MEDICARE: KRISTIN M GREINER RDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	10225819	OR
2	133V00000X	Registered Dietitian	86325251	CO

General Provider Information

NPI Number	:	1225758006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN M GREINER RDN

Provider Business Mailing Address
First Line	:	2448 DELICATO CT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80921-7658
Country	:	US
Telephone Number	:	623-556-6582
Fax Number	:

Provider Business Practice Location Address
First Line	:	2448 DELICATO CT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80921-7658
Country	:	US
Telephone Number	:	623-556-6582
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2022
Last Update Date	:	08/31/2022

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