Provider Demographics
NPI:1679839435
Name:ELMS, CINDY (RD)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:
Last Name:ELMS
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 1:5940 W UNION HILLS DR
Mailing Address - Street 2:SUITE D-200
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-1308
Mailing Address - Country:US
Mailing Address - Phone:928-231-9412
Mailing Address - Fax:
Practice Address - Street 1:5940 W UNION HILLS DR
Practice Address - Street 2:SUITE D-200
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1308
Practice Address - Country:US
Practice Address - Phone:928-231-9412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2016-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered