Provider Demographics
NPI:1043564537
Name:PEARSON, KENDRA (RDN, LDN)
Entity type:Individual
Prefix:MISS
First Name:KENDRA
Middle Name:
Last Name:PEARSON
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5735
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59806-5735
Mailing Address - Country:US
Mailing Address - Phone:909-905-0509
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 5735
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59806-5735
Practice Address - Country:US
Practice Address - Phone:909-905-0509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-05
Last Update Date:2025-01-07
Deactivation Date:2014-12-05
Deactivation Code:
Reactivation Date:2022-05-05
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management