Provider Demographics
NPI:1255016887
Name:KRIEG, KATIE (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:KRIEG
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:PITCHFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:410 CHRISTOPHER CT
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-6009
Mailing Address - Country:US
Mailing Address - Phone:469-324-9589
Mailing Address - Fax:
Practice Address - Street 1:5900 BALCONES DR STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4298
Practice Address - Country:US
Practice Address - Phone:469-324-9589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X, 133NN1002X, 133VN1201X, 174400000X
TXDT87468133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management
No174400000XOther Service ProvidersSpecialist