Provider Demographics
NPI:1518493030
Name:UMBREIT, LYNN (MS, RDN, LD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:UMBREIT
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3923 OXBOW VILLAGE LN NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-1179
Mailing Address - Country:US
Mailing Address - Phone:505-301-6240
Mailing Address - Fax:
Practice Address - Street 1:3923 OXBOW VILLAGE LN NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-1179
Practice Address - Country:US
Practice Address - Phone:505-301-6240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM556133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered