Individual
KIMBERLY STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Contact information
Practice address
2907 PLEASANT VALLEY BLVD, ALTOONA, PA 16602-4305
(814) 943-8164
Mailing address
141 CAMPGROUND RD, EBENSBURG, PA 15931-3903
(814) 242-3038
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN004099
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
979614
COMMISSION ON DIETETIC REGISTRATION
—
01
—
D004099N
PA STATE DEPT BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS
PA
Enumeration date
09/17/2021
Last updated
09/17/2021
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