Provider Demographics
NPI:1396368247
Name:TAUNTON, CAMDEN THAYER (RD)
Entity Type:Individual
Prefix:
First Name:CAMDEN
Middle Name:THAYER
Last Name:TAUNTON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 N EMERSON ST APT 202
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-3734
Mailing Address - Country:US
Mailing Address - Phone:720-224-8851
Mailing Address - Fax:
Practice Address - Street 1:4450 E JEWELL AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4605
Practice Address - Country:US
Practice Address - Phone:303-757-7467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86151916133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered