Provider Demographics
NPI:1336912252
Name:TAYLOR, KENDRA (RDN, LD)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 GORDON AVE
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-2309
Mailing Address - Country:US
Mailing Address - Phone:330-858-7188
Mailing Address - Fax:
Practice Address - Street 1:162 GORDON AVE
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-2309
Practice Address - Country:US
Practice Address - Phone:330-858-7188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered