| Doctor Name: | MS. KIMBERLY KAY KOEVENIG |
| NPI Number: | 1063719672 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD, LD/N, CDE |
| License Number: | ND 637 |
| Business Practice Address: | 311 N Clyde Morris Blvd Suite 440-outpatient Diabetes Education, Halifax Health Daytona Beach, FL - 321142781 |
| Business Phone Number: | 3862584829 |
| Business Fax Number: | 3862553109 |
| Mailing Address: | 1189 Southfork Ct, PORT ORANGE |
| State: | FL |
| Postal Code: | 321292494 |
| Phone Number: | 3865067841 |
| Fax Number: | |
| NPI Enumeration Date: | 02/16/2011 |
| NPI Last Update Date: | 02/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | ND 637 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| 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 |