Provider Demographics
NPI:1982358958
Name:KLENZMAN, RACHEL (RDN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:KLENZMAN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:EICHHOLTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDN
Mailing Address - Street 1:1505 EDITH LN
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37771-7672
Mailing Address - Country:US
Mailing Address - Phone:865-249-5030
Mailing Address - Fax:
Practice Address - Street 1:1505 EDITH LN
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37771-7672
Practice Address - Country:US
Practice Address - Phone:865-249-5030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN86074013133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered