Provider Demographics
NPI:1386410686
Name:GUINN, KASEY LEIGH (RD)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:LEIGH
Last Name:GUINN
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 1:326 ITA ANN LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35757-7428
Mailing Address - Country:US
Mailing Address - Phone:256-694-8416
Mailing Address - Fax:
Practice Address - Street 1:3325 TRIANA BLVD SW STE 201
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-4643
Practice Address - Country:US
Practice Address - Phone:256-694-8416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2555133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered