Provider Demographics
NPI:1134902265
Name:BARON, KENDRA (RDN)
Entity type:Individual
Prefix:MS
First Name:KENDRA
Middle Name:
Last Name:BARON
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 1:1371 BANKERS RD
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-8641
Mailing Address - Country:US
Mailing Address - Phone:517-439-5835
Mailing Address - Fax:
Practice Address - Street 1:1371 BANKERS RD
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-8641
Practice Address - Country:US
Practice Address - Phone:517-439-5835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI86054452133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered