Provider Demographics
NPI:1326815150
Name:KIRILA, LINDSEY (RDN)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:
Last Name:KIRILA
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 1:1060 BROADWAY AVE SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2604
Mailing Address - Country:US
Mailing Address - Phone:330-719-1795
Mailing Address - Fax:
Practice Address - Street 1:1977 NILES RD SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-5118
Practice Address - Country:US
Practice Address - Phone:330-393-6446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD09054133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered