Provider Demographics
NPI:1427365683
Name:MUKERJEE, KAMALINI (RD)
Entity Type:Individual
Prefix:
First Name:KAMALINI
Middle Name:
Last Name:MUKERJEE
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 36830
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-6830
Mailing Address - Country:US
Mailing Address - Phone:702-606-3106
Mailing Address - Fax:702-534-4003
Practice Address - Street 1:170 S GREEN VALLEY PKWY FL 3
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-3132
Practice Address - Country:US
Practice Address - Phone:702-606-3106
Practice Address - Fax:702-534-4003
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV32313DI1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty