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General NPI Number Information
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NPI Number | 1881248698
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Entity Type | Individual
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Provider Name | JANAE KINIKIN RDN
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Gender | Female
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Dates
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Enumeration Date | 07/30/2019
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Last Update Date | 06/17/2026
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Provider Practice Location Address
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Address Line | 111 S 5TH ST
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City | DOUGLAS
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State | WY
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Zip | 82633-2434
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Country | US
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Telephone | 307-358-2122
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Fax | 307-316-0426
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Provider Business Mailing Address
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Address Line | 539 N WIND RIVER DR
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City | DOUGLAS
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State | WY
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Zip | 82633-2027
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Country | US
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Telephone | 385-244-9573
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 86101171
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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