Provider Demographics
NPI:1417329251
Name:KANE, LINDSEY (RD)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:KANE
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 1:402 S 9TH ST APT 3F
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-1318
Mailing Address - Country:US
Mailing Address - Phone:610-291-1246
Mailing Address - Fax:
Practice Address - Street 1:402 S 9TH ST APT 3F
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-1318
Practice Address - Country:US
Practice Address - Phone:610-291-1246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCDN005570133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered