Provider Demographics
NPI:1598221285
Name:SCHIMETZ, KAYLA (MS, RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:
Last Name:SCHIMETZ
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:ALBRECHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LDN
Mailing Address - Street 1:1401 E. STATE STREET
Mailing Address - Street 2:NUTRITION CENTER, CAMELOT TOWER
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61104
Mailing Address - Country:US
Mailing Address - Phone:779-696-4664
Mailing Address - Fax:608-267-8148
Practice Address - Street 1:1401 E. STATE STREET
Practice Address - Street 2:NUTRITION CENTER, CAMELOT TOWER
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61104
Practice Address - Country:US
Practice Address - Phone:779-696-4664
Practice Address - Fax:608-267-8148
Is Sole Proprietor?:No
Enumeration Date:2019-02-18
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164007575133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered