Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | CHR.0007633 | CO |
NPI | 1336664366 |
---|---|
Provider Name | Ms. Kaitlyn J Popp |
First Address | Denver, CO 80212-1748 |
Second Address | Denver, CO 80211-3121 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2017 |
Last Update Date | 10/08/2017 |