Provider Demographics
NPI:1720303696
Name:SEYMOUR, KATE LOUISE (RD, LDN, CSR)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:LOUISE
Last Name:SEYMOUR
Suffix:
Gender:F
Credentials:RD, LDN, CSR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 ROWENA DR
Mailing Address - Street 2:
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-2070
Mailing Address - Country:US
Mailing Address - Phone:814-931-0613
Mailing Address - Fax:
Practice Address - Street 1:802 ROWENA DR
Practice Address - Street 2:
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-2070
Practice Address - Country:US
Practice Address - Phone:814-931-0613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-02
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006788133VN1005X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal