Provider Demographics
NPI:1548288707
Name:HART, GAYA L (RD, LD)
Entity type:Individual
Prefix:
First Name:GAYA
Middle Name:L
Last Name:HART
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:GAYA
Other - Middle Name:L
Other - Last Name:TRIMBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3025 CLAY ST
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-4071
Mailing Address - Country:US
Mailing Address - Phone:270-444-8183
Mailing Address - Fax:270-444-8147
Practice Address - Street 1:3025 CLAY ST
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-4071
Practice Address - Country:US
Practice Address - Phone:270-444-8183
Practice Address - Fax:270-444-8147
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1300133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered