Provider Demographics
NPI:1457176497
Name:HARGETT, CINDY R (RD)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:R
Last Name:HARGETT
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 1:15732 LEBANON CRITTENDEN RD
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:KY
Mailing Address - Zip Code:41092-8226
Mailing Address - Country:US
Mailing Address - Phone:513-703-0214
Mailing Address - Fax:
Practice Address - Street 1:15732 LEBANON CRITTENDEN RD
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:KY
Practice Address - Zip Code:41092-8226
Practice Address - Country:US
Practice Address - Phone:513-703-0214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY121370133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered