Provider Demographics
NPI:1972514255
Name:AUSTIN, CATHERINE (MS, RD, LDN, FADA)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:MS, RD, LDN, FADA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 JEFFERSON AVE
Mailing Address - Street 2:120
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-2127
Mailing Address - Country:US
Mailing Address - Phone:901-577-7440
Mailing Address - Fax:901-577-7413
Practice Address - Street 1:1030 JEFFERSON AVE
Practice Address - Street 2:120
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-2127
Practice Address - Country:US
Practice Address - Phone:901-577-7440
Practice Address - Fax:901-577-7413
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN894132700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes132700000XDietary & Nutritional Service ProvidersDietary Manager
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN894OtherTN DIETETIC ASSOC
549044OtherAMERICAN DIETETIC ASSOCIA