Doctor Name: | BRAD KITTELSON |
NPI Number: | 1003237736 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LRD |
License Number: | 397 |
Business Practice Address: | 1720 University Dr S Fargo, ND - 581034940 |
Business Phone Number: | 7012804474 |
Business Fax Number: | |
Mailing Address: | Po Box 2168, FARGO |
State: | ND |
Postal Code: | 581072168 |
Phone Number: | 7012342119 |
Fax Number: | |
NPI Enumeration Date: | 12/24/2013 |
NPI Last Update Date: | 03/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 397 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ND |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |