NPI 1619419124 · live from the CMS NPI Registry
Kara M Booth, RD
Dietitian, Registered in Lafayette, IN. National Provider Identifier 1619419124, active.
NPI record
| NPI | 1619419124 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 35 Executive Dr, Suite 5, Lafayette, IN 47905 |
| Practice phone | 765-446-8300 |
| Mailing address | 250 N Shadeland Ave, Indianapolis, IN 46219 |
| Enumerated | November 15, 2016 |
| Last updated | August 23, 2022 |
| Sole proprietor | No |
| Other names | Kara Ricketts |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered | 133V00000X | — |
| Dietitian, Registered, Nutrition, Pediatric | 133VN1004X | — |
| Dietitian, Registered primary | 133V00000X | 37002863A (IN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.