Provider Demographics
NPI:1912721341
Name:HAIR, KATHRYN LAUREL (MPH, RD, LD, CNSC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LAUREL
Last Name:HAIR
Suffix:
Gender:F
Credentials:MPH, RD, LD, CNSC
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:LAUREL
Other - Last Name:SHUMAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:8 MOUNTAIN ROSE CT
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-4869
Mailing Address - Country:US
Mailing Address - Phone:864-230-6026
Mailing Address - Fax:
Practice Address - Street 1:8 MOUNTAIN ROSE CT
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-4869
Practice Address - Country:US
Practice Address - Phone:864-230-6026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1512133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered