Doctor Name: | MRS. KYLIE L WALL |
NPI Number: | 1275884215 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.D., L.D. |
License Number: | 3-LD |
Business Practice Address: | 56-119 Pualalea St Kahuku, HI - 967312052 |
Business Phone Number: | 8082939321 |
Business Fax Number: | |
Mailing Address: | 59-578 Kamehameha Hwy, HALEIWA |
State: | HI |
Postal Code: | 967129625 |
Phone Number: | 8082379808 |
Fax Number: | |
NPI Enumeration Date: | 10/01/2012 |
NPI Last Update Date: | 10/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 3-LD |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
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 |