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Individual

KRISTEN DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, RD, CDN

Contact information

Practice address
5413 W GENESEE ST, CAMILLUS, NY 13031-2100
(315) 727-9251
(315) 293-2791
Mailing address
725 IRVING AVE, SUITE 112, SYRACUSE, NY 13210-1632

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
008367
NY
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
008367-1
NY

Other

Enumeration date
05/29/2015
Last updated
04/16/2020
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