Doctor Name: | KAREN LEE PRENDERGAST |
NPI Number: | 1104979558 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD,LD |
License Number: | LD001340 |
Business Practice Address: | 8203 Hazelbrand Rd Ne Covington, GA - 300141510 |
Business Phone Number: | 7707869086 |
Business Fax Number: | 7707860715 |
Mailing Address: | 2570 Riverside Pkwy., P.o. Box 897 LAWRENCEVILLE |
State: | GA |
Postal Code: | 30045 |
Phone Number: | 7703394260 |
Fax Number: | 7703394297 |
NPI Enumeration Date: | 01/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | LD001340 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
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 |