Provider Demographics
NPI:1891232450
Name:SLATKY, JANESSA (RD, LD/N)
Entity Type:Individual
Prefix:
First Name:JANESSA
Middle Name:
Last Name:SLATKY
Suffix:
Gender:F
Credentials:RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 HILLSBORO PIKE
Mailing Address - Street 2:SUITE 314
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-3336
Mailing Address - Country:US
Mailing Address - Phone:615-853-4410
Mailing Address - Fax:
Practice Address - Street 1:4205 HILLSBORO PIKE
Practice Address - Street 2:SUITE 314
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-3336
Practice Address - Country:US
Practice Address - Phone:615-853-4410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN0000002832133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered