Individual
LINDA MOORE PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., R.D., LDN
Contact information
Practice address
591 MERRIWEATHER DR, COLLIERVILLE, TN 38017-1685
(901) 759-9337
(901) 759-7967
Mailing address
PO BOX 81, COLLIERVILLE, TN 38027-0081
(901) 759-9337
(901) 759-7967
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
772
TN
133V00000X
Registered Dietitian
918
AR
133V00000X
Registered Dietitian
D0936
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I713623
MEDICARE PTAN
—
Enumeration date
07/13/2007
Last updated
10/19/2021
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