Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. MISTY MULLINS CLACKUM, RD, CSP, LDN
Active Sole ProprietorRegistered Dietitian · GAINESVILLE, GA
Registration Details
- NPI Number
- 1073944492
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 11, 2013 (12.361549783631 yrs)
- Last Updated
- Jul 26, 2025
- Licenses
-
1250 (TN)LD002340 (GA)LD002340 (GA)LD002340 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1814 TREESORT VWGAINESVILLE, GA, 305065383Browse GA providers · Browse ZIP 30506
- Phone
- 4232845512
- Fax
- 7704700770
- Primary Specialty
-
Registered Dietitian
133V00000X
- Additional Specialty
- Pediatric Nutrition
- Additional Specialty
- Pediatric Critical Care Nutrition
- Additional Specialty
- Registered Dietitian
Other Registered Dietitian Providers in GAINESVILLE, GA
| Name | Credential | NPI |
|---|---|---|
| AMY N ROARK | L..D. | 1699771311 |
| MS. MARIA GABRIELA GALARZA | RD,LD | 1497839401 |
| MISS SONIA JEWEL FERNANDO | R.D., L.D. | 1194846170 |
| SUZANNE C. BURNS | LD | 1740457787 |
| REGINA MARIE SAXTON | RD, LD | 1669630778 |
| MARY ANN CLEVER | RD, LD | 1720226343 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.