Provider Demographics
NPI:1265628028
Name:NARTKER, KRISTY LEA (RDN, LD)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:LEA
Last Name:NARTKER
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:LEA
Other - Last Name:MCKIBBEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, LD
Mailing Address - Street 1:500 WESTOVER DR # 19431
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-8941
Mailing Address - Country:US
Mailing Address - Phone:512-693-7045
Mailing Address - Fax:512-399-9039
Practice Address - Street 1:1635 ROAD 18
Practice Address - Street 2:
Practice Address - City:CONTINENTAL
Practice Address - State:OH
Practice Address - Zip Code:45831-9563
Practice Address - Country:US
Practice Address - Phone:419-890-7358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT89222133V00000X
WV1612133V00000X
OH6049133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered