Provider Demographics
NPI:1770001802
Name:TURNBOW, BETTY LOU (RDN,LDN)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:LOU
Last Name:TURNBOW
Suffix:
Gender:F
Credentials:RDN,LDN
Other - Prefix:
Other - First Name:BETTY
Other - Middle Name:LOU
Other - Last Name:FONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN,LDN
Mailing Address - Street 1:74 HAVERHILL DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-8506
Mailing Address - Country:US
Mailing Address - Phone:731-616-5631
Mailing Address - Fax:
Practice Address - Street 1:295 GERMANTOWN BEND CV
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-7238
Practice Address - Country:US
Practice Address - Phone:901-759-9337
Practice Address - Fax:901-759-7967
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-09
Last Update Date:2017-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN657133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered