Provider Demographics
NPI:1780110239
Name:HOUCHINS, KENDRA L (RDN)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:L
Last Name:HOUCHINS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 BEACHFRONT DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-9106
Mailing Address - Country:US
Mailing Address - Phone:812-217-9210
Mailing Address - Fax:
Practice Address - Street 1:617 BEACHFRONT DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-9106
Practice Address - Country:US
Practice Address - Phone:812-217-9210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37002757A133N00000X, 133V00000X
IN37002747A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist