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NPI Code Detail

MEDICARE: MS. EMMA SICKLES RDN, CLC

MEDICARE: MS. EMMA SICKLES RDN, CLC
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 Dietitian86100386CO
2174N00000XLactation Consultant (Non-RN)325720CO

General Provider Information

NPI Number : 1316802499
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. EMMA SICKLES RDN, CLC
Provider Business Mailing Address
First Line : 7190 COLORADO BLVD STE 200
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-1804
Country : US
Telephone Number : 303-325-3540
Fax Number :
Provider Business Practice Location Address
First Line : 7190 COLORADO BLVD STE 200
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-1804
Country : US
Telephone Number : 303-325-3540
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2025
Last Update Date : 12/19/2025

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