Provider Demographics
NPI:1811002314
Name:WARD, BETTE KYLEEN (RD)
Entity Type:Individual
Prefix:MRS
First Name:BETTE
Middle Name:KYLEEN
Last Name:WARD
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MRS
Other - First Name:KYLEEN
Other - Middle Name:CAMPBELL
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:608 TALLY RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-2727
Mailing Address - Country:US
Mailing Address - Phone:859-269-2569
Mailing Address - Fax:
Practice Address - Street 1:1101 WINCHESTER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-4028
Practice Address - Country:US
Practice Address - Phone:859-225-4595
Practice Address - Fax:859-225-4726
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0036133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal