Provider Demographics
NPI:1659588747
Name:BURNS, KRYSTAL HOLLINGSWORTH (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:KRYSTAL
Middle Name:HOLLINGSWORTH
Last Name:BURNS
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 WHITTLE CT
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-5793
Mailing Address - Country:US
Mailing Address - Phone:615-867-7589
Mailing Address - Fax:
Practice Address - Street 1:1809 MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1522
Practice Address - Country:US
Practice Address - Phone:615-895-0186
Practice Address - Fax:615-278-3355
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001144133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic