Provider Demographics
NPI:1699207738
Name:QUICK, KATELYN (RDN)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:QUICK
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 MCBATH ST
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-2762
Mailing Address - Country:US
Mailing Address - Phone:814-574-3048
Mailing Address - Fax:
Practice Address - Street 1:361 MCBATH ST
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-2762
Practice Address - Country:US
Practice Address - Phone:814-574-3048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005073133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered