Provider Demographics
NPI:1538757778
Name:DUNN, KESHA (RDN)
Entity type:Individual
Prefix:
First Name:KESHA
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6770 HAWAII KAI DR APT 1401
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-1525
Mailing Address - Country:US
Mailing Address - Phone:808-551-2512
Mailing Address - Fax:
Practice Address - Street 1:6770 HAWAII KAI DR APT 1401
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1525
Practice Address - Country:US
Practice Address - Phone:808-551-2512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI86119752133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered