Provider Demographics
NPI:1083019814
Name:CAULEY, KIRA (RDN)
Entity Type:Individual
Prefix:
First Name:KIRA
Middle Name:
Last Name:CAULEY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W STEPHEN FOSTER AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-1465
Mailing Address - Country:US
Mailing Address - Phone:502-349-0160
Mailing Address - Fax:
Practice Address - Street 1:120 W STEPHEN FOSTER AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-1465
Practice Address - Country:US
Practice Address - Phone:502-349-0160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered