Provider Demographics
NPI:1922766724
Name:MOSES, KAITLIN (RD, LDN)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:MOSES
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:
Other - Last Name:SAULTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5504 BRIDGEMAN CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-8538
Mailing Address - Country:US
Mailing Address - Phone:207-951-4180
Mailing Address - Fax:
Practice Address - Street 1:5504 BRIDGEMAN CT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-8538
Practice Address - Country:US
Practice Address - Phone:207-951-4180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-30
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86148610133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered