Provider Demographics
NPI:1598310336
Name:ESPER, KALIE (RD)
Entity Type:Individual
Prefix:
First Name:KALIE
Middle Name:
Last Name:ESPER
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 1:875 S ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-5004
Mailing Address - Country:US
Mailing Address - Phone:717-652-1107
Mailing Address - Fax:717-652-1142
Practice Address - Street 1:4315 LONDONDERRY RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5318
Practice Address - Country:US
Practice Address - Phone:717-909-0290
Practice Address - Fax:717-909-0292
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005725133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADN005725OtherLICENSE