Provider Demographics
NPI:1275239022
Name:KATE DWYER NUTRITION LLC
Entity Type:Organization
Organization Name:KATE DWYER NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DWYER
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:336-692-7838
Mailing Address - Street 1:24 SUMMERGLEN CT
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-9525
Mailing Address - Country:US
Mailing Address - Phone:336-692-7838
Mailing Address - Fax:
Practice Address - Street 1:24 SUMMERGLEN CT
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-9525
Practice Address - Country:US
Practice Address - Phone:336-692-7838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-03
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty