Provider Demographics
NPI:1881204832
Name:DURBIN, KARA (RDN)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:DURBIN
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 1:1448 PAULI ST
Mailing Address - Street 2:
Mailing Address - City:CANAL FULTON
Mailing Address - State:OH
Mailing Address - Zip Code:44614-9334
Mailing Address - Country:US
Mailing Address - Phone:330-285-6553
Mailing Address - Fax:
Practice Address - Street 1:1448 PAULI ST
Practice Address - Street 2:
Practice Address - City:CANAL FULTON
Practice Address - State:OH
Practice Address - Zip Code:44614-9334
Practice Address - Country:US
Practice Address - Phone:330-285-6553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1074762133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered