Individual
MS. KATHLEEN EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
95 BULLDOG BLVD, STE 101, MELBOURNE, FL 32901-3332
(321) 722-9731
(321) 308-0496
Mailing address
95 BULLDOG BLVD, STE 202, MELBOURNE, FL 32901-3332
(321) 727-2990
(321) 724-0455
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
ND970
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0991-0187
NATIONAL CERT BOARD FOR DIABETES EDUCATORS
—
01
—
ND970
DIETITIAN/NUTRITIONIST
FL
Enumeration date
07/27/2006
Last updated
03/06/2012
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