Provider Demographics
NPI:1215049580
Name:HIX, GENELLE WAGER (MS, RD)
Entity type:Individual
Prefix:MRS
First Name:GENELLE
Middle Name:WAGER
Last Name:HIX
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 S LIMESTONE
Mailing Address - Street 2:ROOM J449
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:859-323-5404
Mailing Address - Fax:859-323-8179
Practice Address - Street 1:740 S LIMESTONE
Practice Address - Street 2:ROOM J449
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-323-5404
Practice Address - Fax:859-323-8179
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered