Provider Demographics
NPI:1225339427
Name:PUTT, KRISTEN S (RD/LDN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:S
Last Name:PUTT
Suffix:
Gender:F
Credentials:RD/LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 BERNVILLE ROAD (ROUTE 183)
Mailing Address - Street 2:ST. JOSEPH MEDICAL CENTER
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605
Mailing Address - Country:US
Mailing Address - Phone:610-378-2487
Mailing Address - Fax:610-378-2178
Practice Address - Street 1:145 N. 6TH STREET
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19603-0316
Practice Address - Country:US
Practice Address - Phone:610-378-2100
Practice Address - Fax:610-208-4775
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN000224133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered