Provider Demographics
NPI:1467607739
Name:HORN, KENDRA LEIGH (MS, RDN, LD)
Entity Type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:LEIGH
Last Name:HORN
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:LEIGH
Other - Last Name:PIASECKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RDN, LD
Mailing Address - Street 1:300 E MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:GREEN SPRINGS
Mailing Address - State:OH
Mailing Address - Zip Code:44836-9321
Mailing Address - Country:US
Mailing Address - Phone:580-678-5586
Mailing Address - Fax:
Practice Address - Street 1:300 E MORGAN ST
Practice Address - Street 2:
Practice Address - City:GREEN SPRINGS
Practice Address - State:OH
Practice Address - Zip Code:44836-9321
Practice Address - Country:US
Practice Address - Phone:580-678-5586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-29
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6699133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered