Provider Demographics
NPI:1518709062
Name:GILMORE, KAHLER RUTH (RDN, CD)
Entity type:Individual
Prefix:
First Name:KAHLER
Middle Name:RUTH
Last Name:GILMORE
Suffix:
Gender:F
Credentials:RDN, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4325 S DOREEN CIR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2816
Mailing Address - Country:US
Mailing Address - Phone:229-300-6739
Mailing Address - Fax:
Practice Address - Street 1:4325 S DOREEN CIR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2816
Practice Address - Country:US
Practice Address - Phone:229-300-6739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12945360-4901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered