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General NPI Number Information
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NPI Number | 1336762137
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Entity Type | Individual
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Provider Name | ABIGAIL LEIGH ELDRIDGE RD
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Gender | Female
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Dates
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Enumeration Date | 05/27/2020
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Last Update Date | 05/27/2020
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Provider Practice Location Address
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Address Line | 7700 E ACADEMY BLVD UNIT 102
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City | DENVER
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State | CO
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Zip | 80230-7168
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Country | US
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Telephone | 970-214-6443
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Fax |
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Provider Business Mailing Address
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Address Line | 7700 E ACADEMY BLVD UNIT 102
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City | DENVER
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State | CO
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Zip | 80230-7168
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Country | US
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Telephone | 970-214-6443
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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 | 133VN1005X
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Taxonomy Name | Renal Nutrition Registered Dietitian
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License Number | 932663
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License Number State | CO
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