Provider Demographics
NPI:1356120760
Name:LIVINGS, KAITLYN E (RD)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:E
Last Name:LIVINGS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:E
Other - Last Name:LIVINGS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD
Mailing Address - Street 1:3031 E FORT UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84121-3440
Mailing Address - Country:US
Mailing Address - Phone:205-834-5293
Mailing Address - Fax:
Practice Address - Street 1:3031 E FORT UNION BLVD
Practice Address - Street 2:
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84121-3440
Practice Address - Country:US
Practice Address - Phone:205-834-5293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT86253927133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered