Provider Demographics
NPI:1366810475
Name:ALEXANDER, KERRI LYNNE (MS RD LDN)
Entity type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:LYNNE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MS RD LDN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:195 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-2610
Mailing Address - Country:US
Mailing Address - Phone:401-486-7089
Mailing Address - Fax:401-223-6329
Practice Address - Street 1:830 CHALKSTONE AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-4734
Practice Address - Country:US
Practice Address - Phone:401-273-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-04
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN00807133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered