Provider Demographics
NPI:1295358588
Name:DRUDIK, KATHRYN MARIE (RDN)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARIE
Last Name:DRUDIK
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10465 PARK MEADOWS DR STE 201
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5321
Mailing Address - Country:US
Mailing Address - Phone:303-790-1515
Mailing Address - Fax:303-790-1989
Practice Address - Street 1:10465 PARK MEADOWS DR STE 201
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5321
Practice Address - Country:US
Practice Address - Phone:303-790-1515
Practice Address - Fax:303-790-1989
Is Sole Proprietor?:No
Enumeration Date:2020-05-21
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86080429133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO86080429OtherACADEMY OF NUTRITION AND DIETETICS