Provider Demographics
NPI:1790468841
Name:KAPE, ENVIN (RD)
Entity Type:Individual
Prefix:
First Name:ENVIN
Middle Name:
Last Name:KAPE
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:VINNIE
Other - Middle Name:
Other - Last Name:KAPE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:11824 GREENWAY DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-2169
Mailing Address - Country:US
Mailing Address - Phone:586-208-9114
Mailing Address - Fax:
Practice Address - Street 1:11824 GREENWAY DR
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-2169
Practice Address - Country:US
Practice Address - Phone:586-208-9114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI86299583133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered