Provider Demographics
NPI:1740649508
Name:SWARTZENTRUBER, KAYE (RD, LPN)
Entity type:Individual
Prefix:
First Name:KAYE
Middle Name:
Last Name:SWARTZENTRUBER
Suffix:
Gender:F
Credentials:RD, LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:852 MERRIMON AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-2405
Mailing Address - Country:US
Mailing Address - Phone:828-251-6092
Mailing Address - Fax:828-251-6911
Practice Address - Street 1:852 MERRIMON AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-2405
Practice Address - Country:US
Practice Address - Phone:828-251-6092
Practice Address - Fax:828-251-6911
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003144133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered