Provider Demographics
NPI:1316779036
Name:WHITTINGTON, STACY (RDN)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:WHITTINGTON
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 MAIN ST STE M1
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-3603
Mailing Address - Country:US
Mailing Address - Phone:615-709-0903
Mailing Address - Fax:855-634-2216
Practice Address - Street 1:615 MAIN ST STE M1
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-3603
Practice Address - Country:US
Practice Address - Phone:615-709-0903
Practice Address - Fax:855-634-2216
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3215133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered