MEDICARE: KATELYN MCKENZIE LEMAIR MS, RD,CSSD,LD

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	119181	IA
2	133V00000X	Registered Dietitian	2423	KS
3	133V00000X	Registered Dietitian	2023012539	MO
4	133VN1501X	Sports Dietetics Nutrition Registered Dietitian	86020609	KS

General Provider Information

NPI Number	:	1962103416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN MCKENZIE LEMAIR MS, RD,CSSD,LD

Provider Business Mailing Address
First Line	:	1823 COLLEGE AVE
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66502-3381
Country	:	US
Telephone Number	:	785-323-6018
Fax Number	:

Provider Business Practice Location Address
First Line	:	1823 COLLEGE AVE
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66502-3381
Country	:	US
Telephone Number	:	785-323-6018
Fax Number	:

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

Provider Enumeration Date	:	03/13/2023
Last Update Date	:	04/08/2023

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