Provider Demographics
NPI:1962286203
Name:KAHN, HEATHER LYN (RD)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:LYN
Last Name:KAHN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 HAISLEY DR # A
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-3406
Mailing Address - Country:US
Mailing Address - Phone:248-342-5771
Mailing Address - Fax:
Practice Address - Street 1:2420 HAISLEY DR # A
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-3406
Practice Address - Country:US
Practice Address - Phone:248-342-5771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty