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NPI Code Detail

MEDICARE: KARYE RAYBORN RD, LD, IBCLC

MEDICARE:   KARYE  RAYBORN  RD, LD, IBCLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianLD006118GA

General Provider Information

NPI Number : 1184373623
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARYE RAYBORN RD, LD, IBCLC
Provider Business Mailing Address
First Line : 5601 VETERANS PKWY
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-9001
Country : US
Telephone Number : 706-321-6215
Fax Number : 706-321-6295
Provider Business Practice Location Address
First Line : 5601 VETERANS PKWY
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-9001
Country : US
Telephone Number : 706-321-6215
Fax Number : 706-321-6295
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2022
Last Update Date : 03/22/2022

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Directions to “ KARYE RAYBORN RD, LD, IBCLC” Practice Location

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