Provider Demographics
NPI:1639656564
Name:ELLIOTT, SYDNEY READ (MS, RDN)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:READ
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2226 BYRON AVE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-1384
Mailing Address - Country:US
Mailing Address - Phone:615-714-5076
Mailing Address - Fax:
Practice Address - Street 1:1272 GARRISON DR
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2598
Practice Address - Country:US
Practice Address - Phone:615-867-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN0000003346133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered