Provider Demographics
NPI:1427283738
Name:SHAVER, TAMARA CARR (RD)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:CARR
Last Name:SHAVER
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 1:2229 OLAN MILLS DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1891
Mailing Address - Country:US
Mailing Address - Phone:423-296-4224
Mailing Address - Fax:423-296-4230
Practice Address - Street 1:2229 OLAN MILLS DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1891
Practice Address - Country:US
Practice Address - Phone:423-296-4224
Practice Address - Fax:423-296-4230
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-16
Last Update Date:2009-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN 1401133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered