Provider Demographics
NPI:1679338008
Name:FINCHER, MAKAYLA
Entity Type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:
Last Name:FINCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:282 BESSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BEERSHEBA SPRINGS
Mailing Address - State:TN
Mailing Address - Zip Code:37305-5007
Mailing Address - Country:US
Mailing Address - Phone:931-639-4659
Mailing Address - Fax:
Practice Address - Street 1:851 S WILLOW AVE STE 108
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-4223
Practice Address - Country:US
Practice Address - Phone:931-284-4060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN0000003726133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered