Provider Demographics
NPI:1861049793
Name:NETZ, KATHERINE E (RDN)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:E
Last Name:NETZ
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 1:15027 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-7853
Mailing Address - Country:US
Mailing Address - Phone:515-210-1339
Mailing Address - Fax:
Practice Address - Street 1:15027 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-7853
Practice Address - Country:US
Practice Address - Phone:515-210-1339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA05133133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered