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Organization

KANSAS CITY DIETITIAN LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BETHANY FRAZIER MS, RD, LD (OWNER)
(816) 695-8245
Entity
Organization

Contact information

Practice address
6240 W 156TH ST, OVERLAND PARK, KS 66223-3621
(816) 695-8245
(844) 692-5186
Mailing address
6801 W 121ST ST STE 121, OVERLAND PARK, KS 66209-2005
(816) 695-8245
(844) 692-5186

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1043650609
NPI
01
1417203076
NPI
01
1417388133
NPI
01
1891101309
NPI
Enumeration date
08/21/2019
Last updated
05/23/2021
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