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General NPI Number Information
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NPI Number | 1881509057
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Entity Type | Individual
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Provider Name | KAITLYN NICOLE GRAMBO RDN, CNSC, CDCES
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Gender | Female
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Dates
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Enumeration Date | 08/14/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 3031 W GRAND BLVD
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City | DETROIT
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State | MI
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Zip | 48202-3046
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Country | US
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Telephone | 313-542-2820
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Fax |
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Provider Business Mailing Address
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Address Line | 1 FORD PL
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City | DETROIT
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State | MI
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Zip | 48202-3450
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Country | US
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Telephone | 313-874-7495
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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 |
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License Number State | MI
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