Healthcare Provider Details

I. General information

NPI: 1598905911
Provider Name (Legal Business Name): JULIE KILPATRICK RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE HAYES

II. Dates (important events)

Enumeration Date: 02/25/2009
Last Update Date: 02/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 JOHNSON RD SW
HUNTSVILLE AL
35805-5847
US

IV. Provider business mailing address

3000 JOHNSON RD SW
HUNTSVILLE AL
35805-5847
US

V. Phone/Fax

Practice location:
  • Phone: 256-650-1728
  • Fax: 256-650-1780
Mailing address:
  • Phone: 256-650-1728
  • Fax: 256-650-1780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number1093
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: