Provider Demographics
NPI:1770174518
Name:HADDOCK, EMILY VAUGHAN (RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:VAUGHAN
Last Name:HADDOCK
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BELLE FORREST AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-2219
Mailing Address - Country:US
Mailing Address - Phone:615-500-2951
Mailing Address - Fax:
Practice Address - Street 1:5 BELLE FORREST AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-2219
Practice Address - Country:US
Practice Address - Phone:615-500-2951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3441133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered