Basic Information
| Provider Information | |||||||||
| NPI: | 1154984821 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOTTEL | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | JUNE | ||||||||
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| Credential: | MS, RD, LD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 179 PRINCE GEORGE ST APT D | ||||||||
| Address2: | |||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214011797 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4437584926 | ||||||||
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| Practice Location | |||||||||
| Address1: | 508 IDLEWILD AVE STE 3 | ||||||||
| Address2: | |||||||||
| City: | EASTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216013834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106973832 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2019 | ||||||||
| LastUpdateDate: | 04/23/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 86071521 | MD | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.