Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 3877 | CO |
NPI | 1386765956 |
---|---|
Provider Name | Dr. Carrie Jane Linn |
First Address | Englewood, CO 80155-4394 |
Second Address | Centennial, CO 80112-1409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 08/07/2007 |