Individual
LINDA R GWALTNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS RD LD CDE
Contact information
Practice address
5909 U S HIGHWAY 49, SUITE 30, HATTIESBURG, MS 39402-2860
(601) 296-2780
(601) 296-2781
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 296-2780
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D0251
MS
133V00000X
Registered Dietitian
LD002453
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00882818
—
MS
Enumeration date
08/03/2010
Last updated
08/24/2020
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