Provider Demographics
NPI:1073972642
Name:JAEGERS, KARA BETH (RD LD)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:BETH
Last Name:JAEGERS
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 S HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MO
Mailing Address - Zip Code:65251-2510
Mailing Address - Country:US
Mailing Address - Phone:573-592-6545
Mailing Address - Fax:
Practice Address - Street 1:10 S HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MO
Practice Address - Zip Code:65251-2510
Practice Address - Country:US
Practice Address - Phone:573-592-6545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014029138133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered