Provider Demographics
NPI:1598783003
Name:GILES, KARLA S (RD)
Entity Type:Individual
Prefix:MS
First Name:KARLA
Middle Name:S
Last Name:GILES
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:C B 8126
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-7603
Mailing Address - Fax:314-747-5213
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:5TH FLOOR SUITE C
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-362-7603
Practice Address - Fax:314-747-5213
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001021103133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO013910183Medicaid
MO013910183Medicare PIN
MO013910183Medicaid