Provider Demographics
NPI:1669916920
Name:RENSHAW, KAY HELEN (RD, LD/N)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:HELEN
Last Name:RENSHAW
Suffix:
Gender:F
Credentials:RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9622 SEA TURTLE TER UNIT 102
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-5273
Mailing Address - Country:US
Mailing Address - Phone:813-625-2446
Mailing Address - Fax:
Practice Address - Street 1:9622 SEA TURTLE TER UNIT 102
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34212-5273
Practice Address - Country:US
Practice Address - Phone:813-625-2446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 8037133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered