Provider Demographics
NPI:1316174790
Name:YURMAN, KATY (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:
Last Name:YURMAN
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 1:11 REGENCY RD
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1603
Mailing Address - Country:US
Mailing Address - Phone:706-224-1161
Mailing Address - Fax:770-594-5359
Practice Address - Street 1:11 REGENCY RD
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-1603
Practice Address - Country:US
Practice Address - Phone:706-224-1161
Practice Address - Fax:770-594-5359
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD002789133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered