Provider Demographics
NPI:1114305224
Name:FIELDS, KATHERINE N (RD, CDE)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:N
Last Name:FIELDS
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37086
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3086
Mailing Address - Country:US
Mailing Address - Phone:240-439-8733
Mailing Address - Fax:240-439-8910
Practice Address - Street 1:7211 BANK CT
Practice Address - Street 2:SUITE 240
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-8483
Practice Address - Country:US
Practice Address - Phone:240-215-1454
Practice Address - Fax:240-215-1430
Is Sole Proprietor?:No
Enumeration Date:2015-05-08
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX3481133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered