Provider Demographics
NPI:1912310707
Name:SLUSHER, KRISTEN JACKSON (MS, RD,LDN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:JACKSON
Last Name:SLUSHER
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 1:433 BRAMBLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-4370
Mailing Address - Country:US
Mailing Address - Phone:865-541-8395
Mailing Address - Fax:865-541-8681
Practice Address - Street 1:2018 W CLINCH AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2301
Practice Address - Country:US
Practice Address - Phone:865-541-8395
Practice Address - Fax:865-541-8681
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN0000001919133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered