Provider Demographics
NPI:1932291812
Name:BATTERSBY, BONNIE R (RD LD)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:R
Last Name:BATTERSBY
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 ANNSLEE LN
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-7236
Mailing Address - Country:US
Mailing Address - Phone:770-913-8478
Mailing Address - Fax:
Practice Address - Street 1:7840 ROSWELL RD
Practice Address - Street 2:STE 310
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-6877
Practice Address - Country:US
Practice Address - Phone:770-518-2662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002256133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal