Kristin Nicole Killoran, MS, RDN
Individual provider Active NPI Registered Dietitian · Dededo, GU
NPI 1780466458 · NPPES record last updated Oct 17, 2023
Key facts
- NPI
- 1780466458
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- Practice address
- 655 Harmon Loop Rd Ste 108
Dededo, GU 96929-6544 - Phone
- (671) 633-4447
- NPI assigned
- Oct 17, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Yes |
Addresses
Primary practice location
655 Harmon Loop Rd Ste 108
Dededo, GU 96929-6544
Mailing address
345 Kayen Jose Untalan
Dededo, GU 96929-2494
Other providers in Dededo, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.