Provider Demographics
NPI:1013212174
Name:ANTON, ALISON ELAINE (CNE)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:ELAINE
Last Name:ANTON
Suffix:
Gender:F
Credentials:CNE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 84
Mailing Address - Street 2:
Mailing Address - City:NIWOT
Mailing Address - State:CO
Mailing Address - Zip Code:80544-0084
Mailing Address - Country:US
Mailing Address - Phone:303-652-0930
Mailing Address - Fax:
Practice Address - Street 1:184 5TH AVENUE
Practice Address - Street 2:
Practice Address - City:NIWOT
Practice Address - State:CO
Practice Address - Zip Code:80504
Practice Address - Country:US
Practice Address - Phone:303-652-0930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15-63377-0000133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education