Provider Demographics
NPI:1609656297
Name:OAKES, KATHRYN CECILIA (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:CECILIA
Last Name:OAKES
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MONTPELIER DR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-1287
Mailing Address - Country:US
Mailing Address - Phone:484-467-0861
Mailing Address - Fax:
Practice Address - Street 1:201 MONTPELIER DR
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-1287
Practice Address - Country:US
Practice Address - Phone:484-467-0861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN007648133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered