Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KAY ELIZABETH CORCORAN, RD, LD
ActivePediatric Nutrition · JBLM, WA
Registration Details
- NPI Number
- 1528126729
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 4, 2006 (19.38096107836 yrs)
- Last Updated
- May 13, 2024
- License
-
DI609989935 (WA)
Practice Information
- Address
-
9040A JACKSON AVENUENUTRITION CARE DIVISIONJBLM, WA, 984318952Browse WA providers · Browse ZIP 98431
- Phone
- 2539680549
- Primary Specialty
-
Pediatric Nutrition
133VN1004X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.