Provider Demographics
NPI:1457629164
Name:VANKAT, NATALIE JEAN (RD, LMNT)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:JEAN
Last Name:VANKAT
Suffix:
Gender:F
Credentials:RD, LMNT
Other - Prefix:MISS
Other - First Name:NATALIE
Other - Middle Name:JEAN
Other - Last Name:GROUP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LMNT
Mailing Address - Street 1:4101 WOOLWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-1850
Mailing Address - Country:US
Mailing Address - Phone:402-489-3802
Mailing Address - Fax:
Practice Address - Street 1:4101 WOOLWORTH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-1850
Practice Address - Country:US
Practice Address - Phone:402-489-3802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1020133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered