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Individual

MS. KATHRYN KOLASA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD, LDN, RD

Contact information

Practice address
101 HEART DRIVE, ECU PHYSICIANS FAMILY MEDICINE, GREENVILLE, NC 27834-4300
(252) 744-4611
(252) 744-2056
Mailing address
PO BOX 751069, ECU PHYSICIANS FAMILY MEDICINE, CHARLOTTE, NC 28275-1069

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L000047
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
141R5
BCBSNC
NC
01
710000370
RR MEDICARE
NC
Enumeration date
04/26/2006
Last updated
10/28/2011
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