Provider Demographics
NPI:1538706791
Name:SMITH, NATALIE (CNTP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:CNTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 S COFFMAN ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-6612
Mailing Address - Country:US
Mailing Address - Phone:303-718-1294
Mailing Address - Fax:
Practice Address - Street 1:1041 S COFFMAN ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-6612
Practice Address - Country:US
Practice Address - Phone:303-718-1294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty