Provider Demographics
NPI:1043562408
Name:RAMSEY, KAREN CLARK (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:CLARK
Last Name:RAMSEY
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:MRS
Other - First Name:KAREN
Other - Middle Name:CLARK
Other - Last Name:DOHRENWEND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:5429 COLLEGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:GRACEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32440
Mailing Address - Country:US
Mailing Address - Phone:850-263-4431
Mailing Address - Fax:850-263-3312
Practice Address - Street 1:5429 COLLEGE DRIVE
Practice Address - Street 2:
Practice Address - City:GRACEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32440
Practice Address - Country:US
Practice Address - Phone:850-263-4431
Practice Address - Fax:850-263-3312
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND6134133V00000X
133NN1002X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGR742ZMedicare UPIN