Provider Demographics
NPI:1760852610
Name:SCOTT , MMSC, RD, LDN, CDE, JOAN MARIE (MMSC, RD, LDN, CDE)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:MARIE
Last Name:SCOTT , MMSC, RD, LDN, CDE
Suffix:
Gender:F
Credentials:MMSC, RD, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 TAKOMA AVE
Mailing Address - Street 2:TAKOMA REGIONAL HOSPITAL
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37743-4647
Mailing Address - Country:US
Mailing Address - Phone:423-798-8120
Mailing Address - Fax:
Practice Address - Street 1:401 TAKOMA AVE
Practice Address - Street 2:TAKOMA REGIONAL HOSPITAL
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743-4647
Practice Address - Country:US
Practice Address - Phone:423-798-8120
Practice Address - Fax:423-636-0495
Is Sole Proprietor?:No
Enumeration Date:2015-10-05
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN 616133V00000X
133VN1004X, 133VN1005X, 133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic