Provider Demographics
NPI:1609211804
Name:HORSTMEYER, KATE LYNN (RD LD)
Entity Type:Individual
Prefix:MRS
First Name:KATE
Middle Name:LYNN
Last Name:HORSTMEYER
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 VINE ST
Mailing Address - Street 2:
Mailing Address - City:PANA
Mailing Address - State:IL
Mailing Address - Zip Code:62557-1460
Mailing Address - Country:US
Mailing Address - Phone:217-562-6305
Mailing Address - Fax:217-562-6493
Practice Address - Street 1:109 VINE ST
Practice Address - Street 2:
Practice Address - City:PANA
Practice Address - State:IL
Practice Address - Zip Code:62557-1460
Practice Address - Country:US
Practice Address - Phone:217-562-6305
Practice Address - Fax:217-562-6493
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82723133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered