MEDICARE: LINDY LEMIEUX RD

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
1	133V00000X	Registered Dietitian	945840

General Provider Information

NPI Number	:	1699654855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDY LEMIEUX RD

Provider Business Mailing Address
First Line	:	2231 N MARION ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-5246
Country	:	US
Telephone Number	:	775-771-0902
Fax Number	:

Provider Business Practice Location Address
First Line	:	2231 N MARION ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-5246
Country	:	US
Telephone Number	:	775-771-0902
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2025
Last Update Date	:	08/30/2025

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