Healthcare Provider Details

I. General information

NPI: 1558167114
Provider Name (Legal Business Name): SUSAN ALBRIGHT PHD, MS, RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/24/2025
Certification Date: 02/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3025 SPRINGLAKE CIR W
COLORADO SPRINGS CO
80906-3731
US

IV. Provider business mailing address

3025 SPRINGLAKE CIR W
COLORADO SPRINGS CO
80906-3731
US

V. Phone/Fax

Practice location:
  • Phone: 719-238-3773
  • Fax:
Mailing address:
  • Phone: 719-238-3773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number890331
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number890331
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number890331
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: