Provider Demographics
NPI:1285210716
Name:VERDE, CARI (MS, CNS, LDN)
Entity Type:Individual
Prefix:
First Name:CARI
Middle Name:
Last Name:VERDE
Suffix:
Gender:F
Credentials:MS, CNS, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4824 YORKTOWN BLVD
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-5058
Mailing Address - Country:US
Mailing Address - Phone:614-372-9872
Mailing Address - Fax:
Practice Address - Street 1:12200 TECH RD STE 102
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7871
Practice Address - Country:US
Practice Address - Phone:301-622-2722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX4770133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist