Provider Demographics
NPI:1124337498
Name:MARLOW, KATHRYN MARY (MS,RD,LD)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:MARY
Last Name:MARLOW
Suffix:
Gender:F
Credentials:MS,RD,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24360 HENRY MORGAN BLVD
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33955-1712
Mailing Address - Country:US
Mailing Address - Phone:941-740-7744
Mailing Address - Fax:
Practice Address - Street 1:115 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-3654
Practice Address - Country:US
Practice Address - Phone:941-505-0888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL187133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic