Provider Demographics
NPI:1124414362
Name:COLWELL, BARBARA BANCROFT (RD, CDE)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:BANCROFT
Last Name:COLWELL
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 1:285 W TURN TABLE RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583-1366
Mailing Address - Country:US
Mailing Address - Phone:931-836-3187
Mailing Address - Fax:
Practice Address - Street 1:285 W TURN TABLE RD
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-1366
Practice Address - Country:US
Practice Address - Phone:931-836-3187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered