Provider Demographics
NPI:1497597876
Name:WHITT, DEANNA MARIE (MS, RD, LD, IFNCP)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:MARIE
Last Name:WHITT
Suffix:
Gender:F
Credentials:MS, RD, LD, IFNCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4909 TAYLOR LN
Mailing Address - Street 2:
Mailing Address - City:CATLETTSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41129-9157
Mailing Address - Country:US
Mailing Address - Phone:606-923-6180
Mailing Address - Fax:
Practice Address - Street 1:4909 TAYLOR LN
Practice Address - Street 2:
Practice Address - City:CATLETTSBURG
Practice Address - State:KY
Practice Address - Zip Code:41129-9157
Practice Address - Country:US
Practice Address - Phone:606-923-6180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2384133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered