Provider Demographics
NPI:1730410044
Name:CHAVEZ, JULIANN MARIE (PHD, RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:JULIANN
Middle Name:MARIE
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:PHD, RD, LDN
Other - Prefix:MRS
Other - First Name:JULIANN
Other - Middle Name:MARIE WALKER
Other - Last Name:CHAVEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,RD, LDN
Mailing Address - Street 1:7319 LORIMAR PL
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-8168
Mailing Address - Country:US
Mailing Address - Phone:865-406-7543
Mailing Address - Fax:865-691-5515
Practice Address - Street 1:1124 E WEISGARBER RD STE 200
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2686
Practice Address - Country:US
Practice Address - Phone:865-588-3525
Practice Address - Fax:865-558-6153
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN0000001244133V00000X, 133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric