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NPI Code Detail

MEDICARE: LINDA M STAPLES RD

MEDICARE: LINDA M STAPLES 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
1133V00000XRegistered Dietitian650174CO

General Provider Information

NPI Number : 1982665535
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA M STAPLES RD
Provider Business Mailing Address
First Line : 1441 N 12TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85006-2837
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 615 FAIRHURST ST
Second Line :
City : STERLING
State : CO
Zip : 80751-4564
Country : US
Telephone Number : 970-522-0122
Fax Number : 970-522-8532
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2006
Last Update Date : 12/27/2010

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Directions to “ LINDA M STAPLES RD” Practice Location

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