IndividualActive
Kimberly Koevenig, RD, LD/N, CDE
NPI 1063719672 · Registered Dietitian · Daytona Beach, FL
Provider details
- NPI number
- 1063719672
- Entity type
- Individual
- Primary specialty
- Registered DietitianDietary & Nutritional Service Providers
- Credential
- RD, LD/N, CDE
- Sex
- Female
- Sole proprietor
- Yes
- License
- ND 637 (FL)
Specialties & taxonomies
Dietary & Nutritional Service Providers
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
311 N Clyde Morris Blvd
Suite 440-Outpatient Diabetes Education, Halifax Health
Daytona Beach, FL 32114-2781
Phone: (386) 258-4829
Fax: (386) 255-3109
Street-level locationGet directions
Mailing address
1189 Southfork Ct
Port Orange, FL 32129-2494
Registry dates
- Enumerated
- 2011-02-16
- Last updated
- 2011-02-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.