Provider Demographics
NPI:1114310703
Name:SIEDMAN, KARA (RD, CDE)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:SIEDMAN
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 S WADSWORTH BLVD
Mailing Address - Street 2:D-100
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-5122
Mailing Address - Country:US
Mailing Address - Phone:720-454-0068
Mailing Address - Fax:
Practice Address - Street 1:3333 S WADSWORTH BLVD
Practice Address - Street 2:D-100
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-5122
Practice Address - Country:US
Practice Address - Phone:720-454-0068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-06
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1031734133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered