Provider Demographics
NPI:1821505223
Name:JONES, KATHERINE ANN (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:ANN
Last Name:JONES
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 1:1405 CLOVERLEAF DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-2505
Mailing Address - Country:US
Mailing Address - Phone:571-329-0590
Mailing Address - Fax:
Practice Address - Street 1:1405 CLOVERLEAF DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-2505
Practice Address - Country:US
Practice Address - Phone:571-329-0590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-08
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA86063447133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered