Provider Demographics
NPI:1649091778
Name:PIAZZA, KARI LYN (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:KARI
Middle Name:LYN
Last Name:PIAZZA
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 STONEPOINTE DR
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-8146
Mailing Address - Country:US
Mailing Address - Phone:330-962-1110
Mailing Address - Fax:
Practice Address - Street 1:1345 STONEPOINTE DR
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-8146
Practice Address - Country:US
Practice Address - Phone:330-962-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH08962133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered