Provider Demographics
NPI:1437321197
Name:GILL, COLLEEN ANGELIC (MS, RD)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:ANGELIC
Last Name:GILL
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4770 E ILIFF AVE
Mailing Address - Street 2:SUITE 231
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-6061
Mailing Address - Country:US
Mailing Address - Phone:303-810-8612
Mailing Address - Fax:303-377-2097
Practice Address - Street 1:4770 E ILIFF AVE
Practice Address - Street 2:SUITE 231
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6061
Practice Address - Country:US
Practice Address - Phone:303-810-8612
Practice Address - Fax:303-377-2097
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered