Provider Demographics
NPI:1952528242
Name:LAMB, TIANNE (RD)
Entity Type:Individual
Prefix:
First Name:TIANNE
Middle Name:
Last Name:LAMB
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 1:860 S VILLAGE RD
Mailing Address - Street 2:UNIT P5
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-5830
Mailing Address - Country:US
Mailing Address - Phone:435-688-0869
Mailing Address - Fax:
Practice Address - Street 1:352 E RIVERSIDE DR
Practice Address - Street 2:A9
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-6758
Practice Address - Country:US
Practice Address - Phone:435-251-2883
Practice Address - Fax:435-986-6873
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT930978133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT5708732-4901OtherCERT. DIETITIAN LICENSE
UT930978OtherREGISTERED DIETITIAN