Provider Demographics
NPI:1851683767
Name:COLLING, LINDA CHARLOTTE (RDNLD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:CHARLOTTE
Last Name:COLLING
Suffix:
Gender:F
Credentials:RDNLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4915 MILLBROOK ST.
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66218-9139
Mailing Address - Country:US
Mailing Address - Phone:913-449-2361
Mailing Address - Fax:
Practice Address - Street 1:4915 MILLBROOK ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66218-9139
Practice Address - Country:US
Practice Address - Phone:913-449-2361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1630133N00000X, 133V00000X
MO2010023180133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty