Provider Demographics
NPI:1336905819
Name:DUNN, KATRINA MARIE (RD, CNSC)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:MARIE
Last Name:DUNN
Suffix:
Gender:F
Credentials:RD, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 WESTMEADE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-4665
Mailing Address - Country:US
Mailing Address - Phone:314-498-9910
Mailing Address - Fax:
Practice Address - Street 1:1550 WESTMEADE DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-4665
Practice Address - Country:US
Practice Address - Phone:314-498-9910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019044837133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered