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NPI Code Detail

MEDICARE: CHARLOTTE LAKIN RDN

MEDICARE: CHARLOTTE LAKIN 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
1133V00000XRegistered Dietitian86111641CO

General Provider Information

NPI Number : 1306495726
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLOTTE LAKIN RDN
Provider Business Mailing Address
First Line : CAMPUS DELIVERY 8220
Second Line :
City : FORT COLLINS
State : CO
Zip : 80523-1571
Country : US
Telephone Number : 970-495-5916
Fax Number :
Provider Business Practice Location Address
First Line : 151 W LAKE ST
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-4111
Country : US
Telephone Number : 970-495-5916
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2019
Last Update Date : 09/09/2019

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Directions to “ CHARLOTTE LAKIN RDN” Practice Location

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