Individual
MARSHA M FENDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD, CDE
Contact information
Practice address
2016 S ALABAMA AVE, MONROEVILLE, AL 36460-3044
(251) 575-3111
(251) 743-7493
Mailing address
PO BOX 886, MONROEVILLE, AL 36461-0886
(251) 575-3111
(251) 743-7493
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
130
AL
133VN1006X
Metabolic Nutrition Registered Dietitian
130
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0972-0106
DIABETES EDUCATION CERTIF
AL
01
—
130
DIETITIAN LICENSE
AL
01
—
467211
NATIONAL REGISTRATION NO.
—
Enumeration date
06/07/2007
Last updated
06/19/2014
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