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General NPI Number Information
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NPI Number | 1093535585
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Entity Type | Individual
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Provider Name | SUSAN MARSHALL RD, CSPCC, CNSC
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Gender | Female
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 13123 E 16TH AVE # 270
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City | AURORA
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State | CO
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Zip | 80045-7106
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Country | US
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Telephone | 720-777-4902
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Fax |
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Provider Business Mailing Address
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Address Line | 5628 S QUATAR CT
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City | CENTENNIAL
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State | CO
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Zip | 80015-6005
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Country | US
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Telephone | 530-400-2557
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1401X
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Taxonomy Name | Pediatric Critical Care Nutrition Registered Dietitian
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License Number | 966480
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number | 966480
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License Number State |
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