Provider Demographics
NPI:1982904660
Name:KAYL, CHRISTINE MARIE (RD)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:MARIE
Last Name:KAYL
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 1:1551 INDIAN HILLS DR STE 206
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-1857
Mailing Address - Country:US
Mailing Address - Phone:712-258-4700
Mailing Address - Fax:712-258-4777
Practice Address - Street 1:1551 INDIAN HILLS DR STE 206
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-1857
Practice Address - Country:US
Practice Address - Phone:712-258-4700
Practice Address - Fax:712-258-4777
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0330133V00000X
IA001910133V00000X
NE884133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered