Doctor Name: | MISTY KAY |
NPI Number: | 1730571688 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 8395392-4901 |
Business Practice Address: | 576 E Highway 138 Ste 400 Stansbury Park, UT - 840744028 |
Business Phone Number: | 4358433647 |
Business Fax Number: | |
Mailing Address: | 107 W 2100 N, TOOELE |
State: | UT |
Postal Code: | 840748198 |
Phone Number: | 4352288059 |
Fax Number: | |
NPI Enumeration Date: | 03/02/2015 |
NPI Last Update Date: | 03/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 8395392-4901 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
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 |