Provider Demographics
NPI:1619910205
Name:BURNETT, CLAUDIA LYNN (MS RD LD CDE)
Entity Type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:LYNN
Last Name:BURNETT
Suffix:
Gender:F
Credentials:MS RD LD CDE
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:99 MARINER DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-9537
Mailing Address - Country:US
Mailing Address - Phone:859-967-5653
Mailing Address - Fax:859-313-3132
Practice Address - Street 1:150 N EAGLE CREEK DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1805
Practice Address - Country:US
Practice Address - Phone:859-967-5653
Practice Address - Fax:859-313-3132
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0804133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered