Provider Demographics
NPI:1497030944
Name:RAWSON, KAITLYN (RD)
Entity Type:Individual
Prefix:MRS
First Name:KAITLYN
Middle Name:
Last Name:RAWSON
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 1:14 APPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:LEONARDO
Mailing Address - State:NJ
Mailing Address - Zip Code:07737-1030
Mailing Address - Country:US
Mailing Address - Phone:862-202-4981
Mailing Address - Fax:
Practice Address - Street 1:14 APPLETON AVE
Practice Address - Street 2:
Practice Address - City:LEONARDO
Practice Address - State:NJ
Practice Address - Zip Code:07737-1030
Practice Address - Country:US
Practice Address - Phone:862-202-4981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1068483133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered