MEDICARE: ELDERBERRY RDN 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	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1770411175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELDERBERRY RDN LLC

Provider Business Mailing Address
First Line	:	29 MIDDLE RD
Second Line	:
City	:	DEERFIELD
State	:	NH
Zip	:	03037-1611
Country	:	US
Telephone Number	:	603-494-8543
Fax Number	:

Provider Business Practice Location Address
First Line	:	29 MIDDLE RD
Second Line	:
City	:	DEERFIELD
State	:	NH
Zip	:	03037-1611
Country	:	US
Telephone Number	:	603-494-8543
Fax Number	:

Authorized Official
Title or Position	:	OWNER, DIETITIAN
Name	:	TINA CAROLYN LAYTON
Credential	:	RD, CDCES
Telephone Number	:	603-494-8543

Provider Enumeration Date	:	05/13/2026
Last Update Date	:	05/13/2026

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