Individual
KATELYN MUSTAIN BIANCONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
1311 DOWELL SPRINGS BLVD, SUITE 300, KNOXVILLE, TN 37909-2454
(865) 588-5121
(865) 588-5126
Mailing address
PO BOX 59002, KNOXVILLE, TN 37950-9002
(865) 588-5121
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
2486
LA
133V00000X
Registered Dietitian
Primary
LDN2861
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2486
LOUISIANA LICENSE NUTRITION AND DIETETICS
LA
01
—
2861
LICENSED DIETITIAN NUTRITIONIST
TN
Enumeration date
01/10/2014
Last updated
05/05/2017
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