Provider Demographics
NPI:1568206258
Name:KAY, SAMANTHA MARIE-OFLYNN (RDN)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:MARIE-OFLYNN
Last Name:KAY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:573 W BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-9215
Mailing Address - Country:US
Mailing Address - Phone:734-740-3791
Mailing Address - Fax:
Practice Address - Street 1:573 W BRANCH RD
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-9215
Practice Address - Country:US
Practice Address - Phone:734-740-3791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered