Provider Demographics
NPI:1750069589
Name:TALLMAN, CAROLINE M (RDN)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:M
Last Name:TALLMAN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8601 DUNWOODY PL STE 508
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-2551
Mailing Address - Country:US
Mailing Address - Phone:770-298-6739
Mailing Address - Fax:
Practice Address - Street 1:8601 DUNWOODY PL STE 508
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-2551
Practice Address - Country:US
Practice Address - Phone:770-298-6739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD006163133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered