MEDICARE: KATELIN EMPROTO RD, LDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	L006160	NC

General Provider Information

NPI Number	:	1508478017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELIN EMPROTO RD, LDN

Provider Business Mailing Address
First Line	:	4015 CRAFT ST APT 1215
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-1658
Country	:	US
Telephone Number	:	631-902-2663
Fax Number	:

Provider Business Practice Location Address
First Line	:	13521 STEELECROFT PKWY UNIT D
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28278-7551
Country	:	US
Telephone Number	:	704-315-5845
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2020
Last Update Date	:	09/22/2025

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