Provider Demographics
NPI:1285244897
Name:BUTTS, KAYLA DENISE (MS, RDN, LDN)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:DENISE
Last Name:BUTTS
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:YANDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5922 PARKLAND DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-3814
Mailing Address - Country:US
Mailing Address - Phone:361-563-1239
Mailing Address - Fax:
Practice Address - Street 1:4300 S PADRE ISLAND DR STE 2-2
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4433
Practice Address - Country:US
Practice Address - Phone:361-855-9449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT81151133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered