Provider Demographics
NPI:1477034692
Name:VAN HORN, KYLEE SCHULER (RDN)
Entity Type:Individual
Prefix:
First Name:KYLEE
Middle Name:SCHULER
Last Name:VAN HORN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 OAK RUN RD
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-2811
Mailing Address - Country:US
Mailing Address - Phone:717-816-3592
Mailing Address - Fax:
Practice Address - Street 1:380 OAK RUN RD
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-2811
Practice Address - Country:US
Practice Address - Phone:717-816-3592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-25
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86026478133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered