Provider Demographics
NPI:1043646706
Name:KIRKPATRICK, KRISTIN (MS, RD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 RICHMOND RD
Mailing Address - Street 2:TR2-234
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-3719
Mailing Address - Country:US
Mailing Address - Phone:216-448-8609
Mailing Address - Fax:
Practice Address - Street 1:1950 RICHMOND RD
Practice Address - Street 2:TR2-234
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-3719
Practice Address - Country:US
Practice Address - Phone:216-448-8609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH951265133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered