Provider Demographics
NPI:1083509368
Name:GOING, KERRIN PATRICIA (MS,RD,LDN)
Entity type:Individual
Prefix:
First Name:KERRIN
Middle Name:PATRICIA
Last Name:GOING
Suffix:
Gender:F
Credentials:MS,RD,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86121 REMSENBURG DR
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-8125
Mailing Address - Country:US
Mailing Address - Phone:904-415-1783
Mailing Address - Fax:
Practice Address - Street 1:OUTPATIENT CLINIC HEALTHCARE PLAZA
Practice Address - Street 2:3901 UNIVERSITY BLVD S.
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216
Practice Address - Country:US
Practice Address - Phone:904-345-7310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND3422133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered