Healthcare Provider Details

I. General information

NPI: 1649805458
Provider Name (Legal Business Name): KYRSTIE A LINDHORST RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2020
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 SW 6TH AVE
TOPEKA KS
66606-2806
US

IV. Provider business mailing address

3520 SW 6TH AVE
TOPEKA KS
66606-2806
US

V. Phone/Fax

Practice location:
  • Phone: 785-354-9591
  • Fax:
Mailing address:
  • Phone: 785-354-9591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2392
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: