Provider Demographics
NPI:1164855771
Name:CRANE, CAITLIN ELIZABETH (RD, LDN)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:ELIZABETH
Last Name:CRANE
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 WASHINGTON ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-3651
Mailing Address - Country:US
Mailing Address - Phone:978-835-3293
Mailing Address - Fax:
Practice Address - Street 1:7 RESERVOIR RD
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-5501
Practice Address - Country:US
Practice Address - Phone:978-835-3293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3517133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered