Provider Demographics
NPI:1346280963
Name:BERGER, KATHRYN W (RD)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:W
Last Name:BERGER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0388
Mailing Address - Country:US
Mailing Address - Phone:409-325-1685
Mailing Address - Fax:540-932-5875
Practice Address - Street 1:15 SPORTS MEDICINE DRIVE, STE 101
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939
Practice Address - Country:US
Practice Address - Phone:540-213-2537
Practice Address - Fax:540-213-2522
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD01365133VN1006X
VA660225133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic