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NPI Code Detail

MEDICARE: COURTNEY J KIANG RD

MEDICARE: COURTNEY J KIANG 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
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1871942979
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY J KIANG RD
Provider Business Mailing Address
First Line : 2620 ELM HILL PIKE
Second Line :
City : NASHVILLE
State : TN
Zip : 37214-3108
Country : US
Telephone Number : 615-425-4200
Fax Number : 615-425-4201
Provider Business Practice Location Address
First Line : 11747 W KEN CARYL AVE
Second Line :
City : LITTLETON
State : CO
Zip : 80127-3700
Country : US
Telephone Number : 720-981-2069
Fax Number : 720-981-2070
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2016
Last Update Date : 06/09/2016

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