Organization
BEVINS CROWLEY NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRAN BEVINS CROWLEY RD, LD (AGENT)
(502) 316-8776
Entity
Organization
Contact information
Practice address
640 E LEXINGTON AVE, DANVILLE, KY 40422-1719
(502) 316-8776
(502) 316-8776
Mailing address
1122 TAYLOR RD, DANVILLE, KY 40422-8853
(502) 316-8776
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
629957
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122376
KENTUCKY LICENSURE FOR DIETITIANS
KY
01
—
629957
REGISTERED DIETITIAN
—
Enumeration date
08/28/2017
Last updated
08/28/2017
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