Provider Demographics
NPI:1346889029
Name:HILL, KENDRA A (RD)
Entity Type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:A
Last Name:HILL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:A
Other - Last Name:KEUPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:655 7TH ST BLDG 700-A78
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31098-2227
Mailing Address - Country:US
Mailing Address - Phone:478-497-7664
Mailing Address - Fax:
Practice Address - Street 1:655 7TH ST BLDG 700-A78
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31098-2227
Practice Address - Country:US
Practice Address - Phone:478-497-7664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL86054937133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLND9129OtherSTATE LICENSE