Healthcare Provider Details

I. General information

NPI: 1609384692
Provider Name (Legal Business Name): CARA ANN MARRS RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2018
Last Update Date: 03/13/2020
Certification Date: 03/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 S LINCOLN AVE STE A
STEAMBOAT SPRINGS CO
80487-1790
US

IV. Provider business mailing address

2765 LAUREL LN
STEAMBOAT SPRINGS CO
80487-2061
US

V. Phone/Fax

Practice location:
  • Phone: 970-875-2731
  • Fax: 970-875-2780
Mailing address:
  • Phone: 970-846-6268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number991854
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: