Provider Demographics
NPI:1538395769
Name:MARGER, KATHRYN JEAN (MS,RD,LDN)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:JEAN
Last Name:MARGER
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 1:1005 THORNDALE DR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-4433
Mailing Address - Country:US
Mailing Address - Phone:267-644-7245
Mailing Address - Fax:
Practice Address - Street 1:1860 OLD MORRIS RD
Practice Address - Street 2:
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-3023
Practice Address - Country:US
Practice Address - Phone:215-855-9852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADNOO3376133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103510539Medicaid