Provider Demographics
NPI:1801601802
Name:HELTON, MAKENNA ROSE (RD)
Entity type:Individual
Prefix:
First Name:MAKENNA
Middle Name:ROSE
Last Name:HELTON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7712 DAN LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37938-4553
Mailing Address - Country:US
Mailing Address - Phone:865-679-9300
Mailing Address - Fax:
Practice Address - Street 1:7712 DAN LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37938-4553
Practice Address - Country:US
Practice Address - Phone:865-679-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-08
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4824133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered