Provider Demographics
NPI:1932732344
Name:KAHOUT, ANN CATHERINE (RD)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:CATHERINE
Last Name:KAHOUT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 NORTHWEST BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-2644
Mailing Address - Country:US
Mailing Address - Phone:763-200-1121
Mailing Address - Fax:
Practice Address - Street 1:2905 NORTHWEST BLVD STE 230
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-2644
Practice Address - Country:US
Practice Address - Phone:763-200-1121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-14
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN86010740133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered