Provider Demographics
NPI:1205933660
Name:LUTTER, KATHLEEN A (RD)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:LUTTER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 HOSPITAL ROAD
Mailing Address - Street 2:SPEARE MEMORIAL HOSPITAL, FOOD & NUTRITION SERVICES
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16 HOSPITAL ROAD
Practice Address - Street 2:SPEARE MEMORIAL HOSPITAL, FOOD & NUTRITION SERVICES
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264
Practice Address - Country:US
Practice Address - Phone:603-536-1120
Practice Address - Fax:603-536-4828
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH42OtherNH LICENSE
NH42OtherNH LICENSE