Healthcare Provider Details

I. General information

NPI: 1841568581
Provider Name (Legal Business Name): KATHERINE ZAVODNI MPH, RD/CEDRD, CD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2011
Last Update Date: 04/01/2022
Certification Date: 09/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1848 E HERBERT AVE
SALT LAKE CITY UT
84108-1832
US

IV. Provider business mailing address

1848 E HERBERT AVE
SALT LAKE CITY UT
84108-1832
US

V. Phone/Fax

Practice location:
  • Phone: 919-451-7500
  • Fax:
Mailing address:
  • Phone: 919-451-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number9383810-4901
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: