Provider Demographics
NPI:1326629833
Name:EBERLY, CAITLIN A (NTP, RWS)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:A
Last Name:EBERLY
Suffix:
Gender:F
Credentials:NTP, RWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 JERSEY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-4520
Mailing Address - Country:US
Mailing Address - Phone:717-433-4914
Mailing Address - Fax:
Practice Address - Street 1:810 JERSEY ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-4520
Practice Address - Country:US
Practice Address - Phone:717-433-4914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist