Provider Demographics
NPI:1598499501
Name:MCWATERS, KATHRYN PHILLIPS (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:PHILLIPS
Last Name:MCWATERS
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:NADINE
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, LDN
Mailing Address - Street 1:3146 BELWOOD ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1211
Mailing Address - Country:US
Mailing Address - Phone:949-690-3359
Mailing Address - Fax:
Practice Address - Street 1:2002 EASTLAND AVE STE 101
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-1705
Practice Address - Country:US
Practice Address - Phone:615-697-9355
Practice Address - Fax:615-334-0867
Is Sole Proprietor?:No
Enumeration Date:2022-07-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4300133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered