Provider Demographics
NPI:1962013029
Name:RYAN, CATHERINE (RDN)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:RYAN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 CITY VIEW LN
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507-1545
Mailing Address - Country:US
Mailing Address - Phone:970-270-3531
Mailing Address - Fax:
Practice Address - Street 1:436 CITY VIEW LN
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81507-1545
Practice Address - Country:US
Practice Address - Phone:970-270-3531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO813743133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered