MEDICARE: LAURIE CUSINATO LLC

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	133N00000X	Nutritionist

General Provider Information

NPI Number	:	1750230421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAURIE CUSINATO LLC

Provider Business Mailing Address
First Line	:	PO BOX 373
Second Line	:
City	:	CARBONDALE
State	:	CO
Zip	:	81623-0373
Country	:	US
Telephone Number	:	970-930-5955
Fax Number	:

Provider Business Practice Location Address
First Line	:	159 SPRING PARK RDG
Second Line	:
City	:	CARBONDALE
State	:	CO
Zip	:	81623-9186
Country	:	US
Telephone Number	:	970-930-5955
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LAURIE CUSINATO
Credential	:	MS, CNS, LDN
Telephone Number	:	970-930-5955

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	04/20/2026

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Directions to “LAURIE CUSINATO LLC ” Practice Location

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