MEDICARE: KARNI INC

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	133NN1002X	Nutrition Education Nutritionist	102951-4901	UT
2	133VN1005X	Renal Nutrition Registered Dietitian	102951-4901	UT
3	133VN1006X	Metabolic Nutrition Registered Dietitian	102951-4901	UT

General Provider Information

NPI Number	:	1609140649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KARNI INC

Provider Business Mailing Address
First Line	:	2376 SCENIC DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-1433
Country	:	US
Telephone Number	:	801-574-5731
Fax Number	:	801-487-5798

Provider Business Practice Location Address
First Line	:	2376 SCENIC DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-1433
Country	:	US
Telephone Number	:	801-574-5731
Fax Number	:	801-487-5798

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. KARMEEN D KULKARNI
Credential	:	RD
Telephone Number	:	801-574-5731

Provider Enumeration Date	:	03/07/2012
Last Update Date	:	03/07/2012

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