Provider Demographics
NPI:1578999058
Name:SOWELL, KYMBERLI LEN (RDN)
Entity Type:Individual
Prefix:MRS
First Name:KYMBERLI
Middle Name:LEN
Last Name:SOWELL
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 AIRPORT BLVD # D-436
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-6705
Mailing Address - Country:US
Mailing Address - Phone:251-266-1987
Mailing Address - Fax:251-266-2070
Practice Address - Street 1:6701 AIRPORT BLVD # D-436
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-6705
Practice Address - Country:US
Practice Address - Phone:251-266-1987
Practice Address - Fax:251-266-2070
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-17
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1951133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered