Provider Demographics
NPI:1821641127
Name:CARTER, ERYN (RND, LD)
Entity Type:Individual
Prefix:
First Name:ERYN
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:RND, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 SW INDIAN TRL
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-1350
Mailing Address - Country:US
Mailing Address - Phone:785-250-1390
Mailing Address - Fax:
Practice Address - Street 1:2611 SW 17TH ST STE 270
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604
Practice Address - Country:US
Practice Address - Phone:785-250-1390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2405133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered