Provider Demographics
NPI:1922349893
Name:BIGNELL, WHITNEY ELAINE (MS, RD, LD)
Entity Type:Individual
Prefix:MS
First Name:WHITNEY
Middle Name:ELAINE
Last Name:BIGNELL
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 451
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30683-0451
Mailing Address - Country:US
Mailing Address - Phone:706-296-1572
Mailing Address - Fax:
Practice Address - Street 1:1197 CEDAR SHOALS DR
Practice Address - Street 2:APT. 103
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-5288
Practice Address - Country:US
Practice Address - Phone:706-296-1572
Practice Address - Fax:706-850-0662
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-02
Last Update Date:2013-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD003881133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered