Provider Demographics
NPI:1881966737
Name:GILREATH, KARA D (RD)
Entity type:Individual
Prefix:MISS
First Name:KARA
Middle Name:D
Last Name:GILREATH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-1845
Mailing Address - Country:US
Mailing Address - Phone:304-933-3073
Mailing Address - Fax:304-933-3187
Practice Address - Street 1:351 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-1845
Practice Address - Country:US
Practice Address - Phone:304-933-3073
Practice Address - Fax:304-933-3187
Is Sole Proprietor?:No
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV754133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered