Provider Demographics
NPI:1174094684
Name:BOWLING, KAYLA AMACHER (RDN, LDN)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:AMACHER
Last Name:BOWLING
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:MS
Other - First Name:KAYLA
Other - Middle Name:LYNN
Other - Last Name:AMACHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDN, LDN
Mailing Address - Street 1:3400 LEBANON RD BLDG 9
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-1236
Mailing Address - Country:US
Mailing Address - Phone:615-225-2774
Mailing Address - Fax:
Practice Address - Street 1:3400 LEBANON RD BLDG 9
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1236
Practice Address - Country:US
Practice Address - Phone:615-225-2774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-10
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3087133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered