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General NPI Number Information
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NPI Number | 1598466245
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Entity Type | Individual
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Provider Name | KRISTIN HOLMSKOG RD
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Gender | Female
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Dates
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Enumeration Date | 03/10/2023
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Last Update Date | 03/10/2023
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Provider Practice Location Address
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Address Line | DWIGHT D. EISENHOWER VA MEDICAL CENTER L-120 NUTRITION AND FOOD SERVICE
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City | LEAVENWORTH
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State | KS
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Zip | 66048
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Country | US
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Telephone | 916-682-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 308 W 8TH ST APT 513
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City | KANSAS CITY
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State | MO
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Zip | 64105-1587
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Country | US
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Telephone | 503-810-0083
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 831550
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License Number State |
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