Provider Demographics
NPI:1912415241
Name:BURKHOLDER, CAROLINE ELEANOR (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ELEANOR
Last Name:BURKHOLDER
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-5350
Mailing Address - Country:US
Mailing Address - Phone:770-677-9318
Mailing Address - Fax:
Practice Address - Street 1:301 HIGGINS AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-3000
Practice Address - Country:US
Practice Address - Phone:865-229-6461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-22
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7476101YP2500X
TN4274133V00000X
GALD004968133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional