Provider Demographics
NPI:1619505724
Name:ESPOSITO, MICHELLE LYNN (RD, CSP, LDN, CNSC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:ESPOSITO
Suffix:
Gender:F
Credentials:RD, CSP, LDN, CNSC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:LYNN
Other - Last Name:ESPOSITO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD, CSP, LDN, CNSC
Mailing Address - Street 1:1ST FLOOR RESEARCH CENTER - 50 NORTH DUNLAP ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103
Mailing Address - Country:US
Mailing Address - Phone:901-287-5949
Mailing Address - Fax:901-287-5123
Practice Address - Street 1:1ST FLOOR RESEARCH CENTER - 50 NORTH DUNLAP ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103
Practice Address - Country:US
Practice Address - Phone:901-287-5949
Practice Address - Fax:901-287-5123
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2776133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric