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General NPI Number Information
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NPI Number | 1922903160
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Entity Type | Organization
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Legal Business Name | ENLIGHTENED DIETITIAN LLC
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Dates
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Enumeration Date | 10/08/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 5737 E FLOYD AVE
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City | DENVER
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State | CO
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Zip | 80222-7515
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Country | US
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Telephone | 720-263-0464
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Fax |
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Provider Business Mailing Address
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Address Line | 5737 E FLOYD AVE
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City | DENVER
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State | CO
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Zip | 80222-7515
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Country | US
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Telephone | 720-263-0464
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Fax |
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Authorized Official
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Title or Position | OWNER/ DIETITIAN
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Name | JILL EKLOF
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Credential | RD
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Telephone | 720-263-0464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State | NULL
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