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General NPI Number Information
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NPI Number | 1336035997
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Entity Type | Individual
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Provider Name | KEVIN R FLETCHER JR. RDN
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Gender | Male
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 12/13/2025
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Provider Practice Location Address
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Address Line | 214C PROVIDENCE RD
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City | BROOKLYN
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State | CT
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Zip | 06234-1833
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Country | US
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Telephone | 860-217-2675
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Fax | 860-217-2676
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Provider Business Mailing Address
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Address Line | PO BOX 264
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City | KILLINGLY
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State | CT
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Zip | 06241-0264
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Country | US
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Telephone | 860-217-2675
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Fax | 860-217-2676
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 002927
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | LDN6946
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License Number State | MA
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