Provider Demographics
NPI:1962103416
Name:LEMAIR, KATELYN MCKENZIE (MS, RD,CSSD,LD)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:MCKENZIE
Last Name:LEMAIR
Suffix:
Gender:F
Credentials:MS, RD,CSSD,LD
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:MCKENZIE
Other - Last Name:CONNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1823 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-3381
Mailing Address - Country:US
Mailing Address - Phone:785-323-6018
Mailing Address - Fax:
Practice Address - Street 1:1823 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-3381
Practice Address - Country:US
Practice Address - Phone:785-323-6018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA119181133V00000X
KS2423133V00000X
MO2023012539133V00000X
KS86020609133VN1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered