Provider Demographics
NPI:1639514474
Name:CARDACE, JOYCE A (RD)
Entity Type:Individual
Prefix:MISS
First Name:JOYCE
Middle Name:A
Last Name:CARDACE
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 1:1951 LONDON CARRIAGE GRV
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-6220
Mailing Address - Country:US
Mailing Address - Phone:719-964-5947
Mailing Address - Fax:
Practice Address - Street 1:1951 LONDON CARRIAGE GRV
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-6220
Practice Address - Country:US
Practice Address - Phone:719-964-5947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered