Provider Demographics
NPI:1902663511
Name:KB NUTRITION COUNSELING
Entity Type:Organization
Organization Name:KB NUTRITION COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN NUTRITIONIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDENBURGER
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:651-395-7315
Mailing Address - Street 1:725 COUNTRY LAKES DR
Mailing Address - Street 2:
Mailing Address - City:LINO LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:55014-5489
Mailing Address - Country:US
Mailing Address - Phone:651-214-5480
Mailing Address - Fax:
Practice Address - Street 1:2355 HIGHWAY 36 W STE 400
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-3905
Practice Address - Country:US
Practice Address - Phone:651-395-7315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty