National Provider Identifier

Kennette Marie Carlson, MBA, RD, CDN

Kennette Marie Carlson, MBA, RD, CDN is listed in the NPPES registry with a primary specialty of Registered Dietitian in Buffalo, NY and a listed phone number of (716) 834-9200.

NPI 1154349363Buffalo, NYRegistered Dietitian

Profile Overview

NPI
1154349363
Provider Type
Individual
Primary Specialty
Registered Dietitian
Enumeration Date
July 17, 2006
Last Updated
July 08, 2007

Practice Location

  • 3495 Bailey Ave
  • Mail Code 528/120
  • Buffalo, NY 14215-1129

Phone: (716) 834-9200

Mailing Address

  • 1186 Nash RD
  • North Tonawanda, NY 14120-2961

Specialties

  • Registered Dietitian (133V00000X)
Full Record
NPI
1154349363
Entity Type
Individual
Last Name
Carlson
First Name
Kennette
Middle Name
Marie
Name Prefix
MS.
Credential
MBA, RD, CDN
Mailing Street Address
1186 Nash RD
Mailing City
North Tonawanda
Mailing State
NY
Mailing ZIP Code
14120-2961
Mailing Country
US
Mailing Phone
(716) 834-9200
Mailing Fax
(716) 862-6374
Practice Street Address
3495 Bailey Ave
Practice Address Line 2
Mail Code 528/120
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14215-1129
Practice Country
US
Practice Phone
(716) 834-9200
Practice Fax
(716) 862-6374
Enumeration Date
July 17, 2006
Last Updated
July 08, 2007
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Registered Dietitian (133V00000X)