Provider Demographics
NPI:1669681235
Name:ONDREJCAK, DENISE D (MS, RD, LDN)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:D
Last Name:ONDREJCAK
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 WHEATON HALL LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-4342
Mailing Address - Country:US
Mailing Address - Phone:615-512-2863
Mailing Address - Fax:
Practice Address - Street 1:106 WHEATON HALL LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37069-4342
Practice Address - Country:US
Practice Address - Phone:615-512-2863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2013-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN0000000936133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered