Kitslaar, Lynn M

Kitslaar, Lynn M is an individual health care provider with primary practice located at 1630 Commanche Ave , Green Bay WI 54313-5753. She recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutrition, Metabolic, Dietary & Nutritional Service Providers / Dietitian, Registered. Dietary & Nutritional Service Providers / Dietitian, Registered is her primary health care specialty. Kitslaar, Lynn M can be contacted via phone (920) 430-4700.

Contact Information

Primary practice address
1630 Commanche Ave Green Bay WI 54313-5753
Phone: (920) 430-4700
Fax: (920) 430-4747
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutrition, Metabolic 133VN1006X 1399-29 Wisconsin
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 1399-29 Wisconsin

Profile Details

NPI number 1255316717
LBN Legal business name Kitslaar, Lynn M
Credentials Registered Dietitian (RD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2005
Last updated Aug 21st, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255316717 NPPES
Wisconsin Other 20110340 NATIONAL CERTIFICATION BOARD FOR DIABETES EDUCATORS
Wisconsin Other 850912 NATIONAL CERTIFICATION BOARD FOR DIABETES EDUCATORS

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