Provider Demographics
NPI:1457682932
Name:PAIGE, LISA (RD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:PAIGE
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 1:7156 W CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-5604
Mailing Address - Country:US
Mailing Address - Phone:303-829-0242
Mailing Address - Fax:
Practice Address - Street 1:7156 W CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-5604
Practice Address - Country:US
Practice Address - Phone:303-972-1619
Practice Address - Fax:303-972-2856
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-22
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
973960OtherAMERICAN DIETETIC ASSOCIATION