Provider Demographics
NPI:1700926342
Name:LIPARI, KATHRYN ANN (RD, CD)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ANN
Last Name:LIPARI
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10737 HENDRICKS PL
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-2926
Mailing Address - Country:US
Mailing Address - Phone:219-661-1769
Mailing Address - Fax:
Practice Address - Street 1:1400 S LAKE PARK AVE STE 200
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-6790
Practice Address - Country:US
Practice Address - Phone:219-947-6122
Practice Address - Fax:219-947-6045
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37001630A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered