Provider Demographics
NPI:1063305217
Name:FLOYD, VARISSA BETHANIE (RDN)
Entity type:Individual
Prefix:
First Name:VARISSA
Middle Name:BETHANIE
Last Name:FLOYD
Suffix:
Gender:X
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3044 LAWSON DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-6418
Mailing Address - Country:US
Mailing Address - Phone:678-720-7126
Mailing Address - Fax:
Practice Address - Street 1:3044 LAWSON DR
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-6418
Practice Address - Country:US
Practice Address - Phone:678-720-7126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD007687133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered