Healthcare Provider Details
I. General information
NPI: 1639028228
Provider Name (Legal Business Name): KH NUTRITION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/26/2026
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2967 E CANYON CREST DR
SPANISH FORK UT
84660-8936
US
IV. Provider business mailing address
2967 E CANYON CREST DR
SPANISH FORK UT
84660-8936
US
V. Phone/Fax
- Phone: 385-437-2588
- Fax: 385-475-4656
- Phone: 385-437-2588
- Fax: 385-475-4656
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KATRISHA
HAWKS
Title or Position: DIETITIAN
Credential: RD, CD
Phone: 385-437-2588