Provider Demographics
NPI:1811362239
Name:TAYLOR, HOLLY K (MS, RD, CNSC)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:K
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS, RD, CNSC
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:K
Other - Last Name:SCROGGIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 MILLARD LN
Mailing Address - Street 2:
Mailing Address - City:BLOUNTVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37617-5449
Mailing Address - Country:US
Mailing Address - Phone:423-483-1457
Mailing Address - Fax:
Practice Address - Street 1:104 MILLARD LN
Practice Address - Street 2:
Practice Address - City:BLOUNTVILLE
Practice Address - State:TN
Practice Address - Zip Code:37617-5449
Practice Address - Country:US
Practice Address - Phone:423-483-1457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic