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General NPI Number Information
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NPI Number | 1073281127
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Entity Type | Individual
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Provider Name | LEANNE M KRAFT
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Gender | Female
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 203 304 MAIN STREET S 125
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City | AIRDRIE
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State | AB
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Zip | T4B3C3
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Country | CA
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Telephone | 702-423-3668
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Fax |
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Provider Business Mailing Address
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Address Line | 203 304 MAIN STREET S. 125
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City | AIRDRIE
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State | ALBERTA
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Zip | T4B3C3
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Country | CA
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | CHN328808
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License Number State | ZZ
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