Provider Demographics
NPI:1619364692
Name:LINDSAY, KAETI (RD, LD)
Entity Type:Individual
Prefix:
First Name:KAETI
Middle Name:
Last Name:LINDSAY
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 1:220 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-1438
Mailing Address - Country:US
Mailing Address - Phone:706-296-2781
Mailing Address - Fax:
Practice Address - Street 1:4056 WETHERBURN WAY
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-4608
Practice Address - Country:US
Practice Address - Phone:678-736-4340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD004403133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered