Provider Demographics
NPI:1598094419
Name:BURTON, KATHRYN ANN (RD, CDE)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:ANN
Last Name:BURTON
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:KELLY
Other - Last Name:BURTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD,CDE
Mailing Address - Street 1:3200 VINE STREET
Mailing Address - Street 2:VA MEDICAL CENTER
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220
Mailing Address - Country:US
Mailing Address - Phone:513-861-3100
Mailing Address - Fax:513-487-6078
Practice Address - Street 1:3200 VINE ST
Practice Address - Street 2:VA MEDICAL CENTER, RESEARCH (151)
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2213
Practice Address - Country:US
Practice Address - Phone:513-861-3100
Practice Address - Fax:513-487-6078
Is Sole Proprietor?:No
Enumeration Date:2009-12-24
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD 731133V00000X
KY0241133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered