Provider Demographics
NPI:1255650909
Name:KERN, ISABELLE (RD, LD, CDE)
Entity Type:Individual
Prefix:MRS
First Name:ISABELLE
Middle Name:
Last Name:KERN
Suffix:
Gender:F
Credentials:RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 N ORANGE AVE STE 542
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4674
Mailing Address - Country:US
Mailing Address - Phone:407-303-5972
Mailing Address - Fax:
Practice Address - Street 1:2501 N ORANGE AVE STE 542
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4674
Practice Address - Country:US
Practice Address - Phone:407-303-5972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND3610133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered