Provider Demographics
NPI:1134478928
Name:MCCLANAHAN, KAYLA R (RDN, LD, CNSC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:R
Last Name:MCCLANAHAN
Suffix:
Gender:F
Credentials:RDN, LD, CNSC
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:R
Other - Last Name:FOLLMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-7293
Mailing Address - Fax:319-356-8674
Practice Address - Street 1:1875 WOODWINDS DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2298
Practice Address - Country:US
Practice Address - Phone:651-232-6800
Practice Address - Fax:651-232-6802
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002066133V00000X
MN4745133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered