Provider Demographics
NPI:1518391093
Name:MORRIS, KYLA RAE (RD)
Entity Type:Individual
Prefix:MISS
First Name:KYLA
Middle Name:RAE
Last Name:MORRIS
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 1:2117 21ST ST SE
Mailing Address - Street 2:APT 29
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-3499
Mailing Address - Country:US
Mailing Address - Phone:704-699-5775
Mailing Address - Fax:
Practice Address - Street 1:630 4TH ST SW
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-2837
Practice Address - Country:US
Practice Address - Phone:828-328-5671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004239133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered