Healthcare Provider Details

I. General information

NPI: 1639997372
Provider Name (Legal Business Name): NATALIE KRAVAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1954 E SUNSET DR
LAYTON UT
84040-5711
US

IV. Provider business mailing address

1954 E SUNSET DR
LAYTON UT
84040-5711
US

V. Phone/Fax

Practice location:
  • Phone: 913-850-9221
  • Fax:
Mailing address:
  • Phone: 913-850-9221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number141866884901
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDT87219
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: