Provider Demographics
NPI:1497156483
Name:REUTZEL, KATHARINE LOVE (MS, RD, LMNT)
Entity Type:Individual
Prefix:MRS
First Name:KATHARINE
Middle Name:LOVE
Last Name:REUTZEL
Suffix:
Gender:F
Credentials:MS, RD, LMNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5505 N 92ND AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-1828
Mailing Address - Country:US
Mailing Address - Phone:402-202-3576
Mailing Address - Fax:
Practice Address - Street 1:19500 PACIFIC ST
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-2726
Practice Address - Country:US
Practice Address - Phone:402-614-6287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1076133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered