Provider Demographics
NPI:1548083033
Name:ASHBURN, KATARINA MARIA (RD)
Entity type:Individual
Prefix:
First Name:KATARINA
Middle Name:MARIA
Last Name:ASHBURN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7511 TURNER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40014-8973
Mailing Address - Country:US
Mailing Address - Phone:703-994-2340
Mailing Address - Fax:
Practice Address - Street 1:7511 TURNER RIDGE RD
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:KY
Practice Address - Zip Code:40014-8973
Practice Address - Country:US
Practice Address - Phone:703-994-2340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY291772133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered