Provider Demographics
NPI:1457562654
Name:LOVE, KATHRYN CONRADT (MS, RD)
Entity type:Individual
Prefix:MISS
First Name:KATHRYN
Middle Name:CONRADT
Last Name:LOVE
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 PORTOFINO WAY APT 106
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-8101
Mailing Address - Country:US
Mailing Address - Phone:561-252-7865
Mailing Address - Fax:
Practice Address - Street 1:4510 PORTOFINO WAY APT 106
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-8101
Practice Address - Country:US
Practice Address - Phone:561-252-7865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
915825133N00000X, 133NN1002X
FLND4663133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133N00000XDietary & Nutritional Service ProvidersNutritionist
Not Answered133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered