Provider Demographics
NPI:1619317021
Name:GILES-SMITH, KAREN LYNN (RD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:GILES-SMITH
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 1:1151 MICHIGAN AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-4069
Mailing Address - Country:US
Mailing Address - Phone:517-969-3109
Mailing Address - Fax:
Practice Address - Street 1:1151 MICHIGAN AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-4069
Practice Address - Country:US
Practice Address - Phone:517-969-3109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-29
Last Update Date:2013-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered