Provider Demographics
NPI:1639689730
Name:CALVELAGE, ELIZABETH MARIE-VENNEFRON (RDN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARIE-VENNEFRON
Last Name:CALVELAGE
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3108
Mailing Address - Country:US
Mailing Address - Phone:615-425-4200
Mailing Address - Fax:
Practice Address - Street 1:555 RACE ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-2347
Practice Address - Country:US
Practice Address - Phone:855-699-6937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2011133V00000X
NCL006002133V00000X
DCDI200001551133V00000X
OHLD.08340133V00000X
IN37003143A133V00000X
AR1928133V00000X
OHAPP-000117635133V00000X
WV1276133V00000X
MEDI1732133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered