Provider Demographics
NPI:1497020309
Name:KAMRATH, KRISTYN M (RD, LD, LMNT)
Entity Type:Individual
Prefix:
First Name:KRISTYN
Middle Name:M
Last Name:KAMRATH
Suffix:
Gender:F
Credentials:RD, LD, LMNT
Other - Prefix:
Other - First Name:KRISTYN
Other - Middle Name:M
Other - Last Name:LASSEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD, LMNT
Mailing Address - Street 1:24931 DENNIS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-8509
Mailing Address - Country:US
Mailing Address - Phone:402-321-5560
Mailing Address - Fax:
Practice Address - Street 1:24931 DENNIS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-8509
Practice Address - Country:US
Practice Address - Phone:402-321-5560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE683133V00000X
NE890337133V00000X
IA1773133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered