Provider Demographics
NPI:1588169262
Name:DUENSING, KYLIE MICHELLE (RDN)
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:MICHELLE
Last Name:DUENSING
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 1:98 N 1100 E STE 302
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2947
Mailing Address - Country:US
Mailing Address - Phone:801-492-2290
Mailing Address - Fax:
Practice Address - Street 1:98 N 1100 E STE 302
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2947
Practice Address - Country:US
Practice Address - Phone:801-492-2290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86081201133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered