Provider Demographics
NPI:1679023758
Name:WEITZEL, CARRIE ANN (RD)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:ANN
Last Name:WEITZEL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8600 RALSTON RD STE 112
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-2373
Mailing Address - Country:US
Mailing Address - Phone:720-722-3438
Mailing Address - Fax:844-364-8548
Practice Address - Street 1:8600 RALSTON RD STE 112
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-2373
Practice Address - Country:US
Practice Address - Phone:720-722-3438
Practice Address - Fax:844-364-8548
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-12
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1039668133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered