Provider Demographics
NPI:1326143199
Name:JONES, KATHRYN S (RD, CDE)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:S
Last Name:JONES
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3553 VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-4011
Mailing Address - Country:US
Mailing Address - Phone:540-597-3800
Mailing Address - Fax:
Practice Address - Street 1:1030 S JEFFERSON ST
Practice Address - Street 2:SUITE G101
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4418
Practice Address - Country:US
Practice Address - Phone:540-224-4371
Practice Address - Fax:540-224-4357
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA947890133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA947890OtherCERTIFICATION NUMBER