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NPI Code Detail

MEDICARE: MRS. CARRIE RODSTROM MS, RDN, LDN

MEDICARE: MRS. CARRIE RODSTROM MS, RDN, LDN
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 Dietitian928145OH

General Provider Information

NPI Number : 1518893767
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARRIE RODSTROM MS, RDN, LDN
Provider Business Mailing Address
First Line : 91 N OVIATT ST
Second Line :
City : HUDSON
State : OH
Zip : 44236-3043
Country : US
Telephone Number : 216-272-6315
Fax Number :
Provider Business Practice Location Address
First Line : 91 N OVIATT ST
Second Line :
City : HUDSON
State : OH
Zip : 44236-3043
Country : US
Telephone Number : 216-272-6315
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2026
Last Update Date : 06/23/2026

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