Provider Demographics
NPI:1518350289
Name:CLOWES, KRISTIN KELLY (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:KELLY
Last Name:CLOWES
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 MACGREGOR PINES DR STE 206
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6037
Mailing Address - Country:US
Mailing Address - Phone:919-889-7012
Mailing Address - Fax:
Practice Address - Street 1:160 MACGREGOR PINES DR
Practice Address - Street 2:SUITE 310
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511
Practice Address - Country:US
Practice Address - Phone:919-234-4468
Practice Address - Fax:919-313-1276
Is Sole Proprietor?:No
Enumeration Date:2015-03-05
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004473133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered