Provider Demographics
NPI:1053036194
Name:HOLLADAY, KATIE ALLISON (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:ALLISON
Last Name:HOLLADAY
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 WHISPERING WOODS RD
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-7052
Mailing Address - Country:US
Mailing Address - Phone:502-974-3606
Mailing Address - Fax:
Practice Address - Street 1:633 WHISPERING WOODS RD
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-7052
Practice Address - Country:US
Practice Address - Phone:502-974-3606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.09928133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered