Provider Demographics
NPI:1417158403
Name:CARRINGTON, MARJORIE JANE (RD)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:JANE
Last Name:CARRINGTON
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 1:2316 RAPIDS DR
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53404-2011
Mailing Address - Country:US
Mailing Address - Phone:262-637-7750
Mailing Address - Fax:
Practice Address - Street 1:2316 RAPIDS DR
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53404-2011
Practice Address - Country:US
Practice Address - Phone:262-637-7750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered