Provider Demographics
NPI:1245691500
Name:SMITH, ANNA VICTORIA (MS, RDN, LDN)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:VICTORIA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:BAFUNNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2620 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3108
Mailing Address - Country:US
Mailing Address - Phone:615-425-4211
Mailing Address - Fax:615-425-4201
Practice Address - Street 1:7087 HIGHWAY 70 S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-2269
Practice Address - Country:US
Practice Address - Phone:615-393-6490
Practice Address - Fax:615-393-6491
Is Sole Proprietor?:No
Enumeration Date:2016-03-15
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3017133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered