Provider Demographics
NPI:1114599065
Name:WATKINS, LINDSAY CRANDALL (RD, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:CRANDALL
Last Name:WATKINS
Suffix:
Gender:F
Credentials:RD, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 AGNES AVE
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-8731
Mailing Address - Country:US
Mailing Address - Phone:406-544-3576
Mailing Address - Fax:
Practice Address - Street 1:214 AGNES AVE
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-8731
Practice Address - Country:US
Practice Address - Phone:406-544-3576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT34857133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered