Provider Demographics
NPI:1891592721
Name:REPPERT-MOYER, CAITLYN ROSE (RD)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:ROSE
Last Name:REPPERT-MOYER
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 LONGVIEW RD
Mailing Address - Street 2:
Mailing Address - City:BOYERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19512-8091
Mailing Address - Country:US
Mailing Address - Phone:484-374-8747
Mailing Address - Fax:
Practice Address - Street 1:1627 CHEW ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-3698
Practice Address - Country:US
Practice Address - Phone:610-969-4992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered