Basic Information
| Provider Information | |||||||||
| NPI: | 1568851830 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOODE | ||||||||
| FirstName: | MURRA | ||||||||
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| Credential: | R.D., L.D.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6799 GREAT OAKS RD | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381382588 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9012610700 | ||||||||
| FaxNumber: | 9012610701 | ||||||||
| Practice Location | |||||||||
| Address1: | 3025 KATE BOND RD | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381334004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9013840065 | ||||||||
| FaxNumber: | 9012661165 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2015 | ||||||||
| LastUpdateDate: | 01/09/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | LDN0000001047 | TN | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.