Provider Demographics
NPI:1053979690
Name:HUNT, VANESSA LYNN (RD)
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:LYNN
Last Name:HUNT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 382
Mailing Address - Street 2:
Mailing Address - City:SCOTTDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30079-0382
Mailing Address - Country:US
Mailing Address - Phone:404-819-4316
Mailing Address - Fax:
Practice Address - Street 1:4276 COURTSIDE DR
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-1292
Practice Address - Country:US
Practice Address - Phone:404-819-4316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD002355133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal