Anne Nicole Kendrick, RDN

Individual provider Active NPI Registered Dietitian · Bluffdale, UT

NPI 1407259609 · NPPES record last updated Oct 1, 2014

Key facts

NPI
1407259609
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
8321366-4901 (UT)
Practice address
2946 W 14400 S
Bluffdale, UT 84065-5008
Phone
(801) 673-3238
NPI assigned
Oct 1, 2014
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
8321366-4901UTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 8321366-4901 UT Yes

Addresses

Primary practice location

2946 W 14400 S
Bluffdale, UT 84065-5008

Mailing address

2946 W 14400 S
Bluffdale, UT 84065-5008
Phone (801) 673-3238

Other providers in Bluffdale, UT

All providers in Bluffdale, UT · Registered Dietitian in Utah

Sources for this page

Verify at the official NPI Registry.