MEDICARE: CATHERINE MEREDITH RD

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	133VN1005X	Renal Nutrition Registered Dietitian
2	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1538707427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE MEREDITH RD

Provider Business Mailing Address
First Line	:	5818 BEELER CT
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80238-2376
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5818 BEELER CT
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80238-2376
Country	:	US
Telephone Number	:	303-349-7233
Fax Number	:

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

Provider Enumeration Date	:	12/11/2019
Last Update Date	:	12/11/2019

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