Provider Demographics
NPI:1811527393
Name:SIMS, KATHRYN E (RDN, LDN)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:E
Last Name:SIMS
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 CENTURY PARK E FL 24
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2302
Mailing Address - Country:US
Mailing Address - Phone:888-219-5299
Mailing Address - Fax:
Practice Address - Street 1:1470 ALPHADA AVE APT M1
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-2718
Practice Address - Country:US
Practice Address - Phone:330-606-2752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6078133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered