Individual
KELLY HAWTHORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
3801 SPRINGHURST BLVD, STE 104, LOUISVILLE, KY 40241-6137
(502) 594-0378
Mailing address
4008 DEER CREEK RD, LOUISVILLE, KY 40241-1578
(502) 594-0378
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
BDNDTN00221280
KY
Other
Enumeration date
01/12/2016
Last updated
01/12/2016
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