Provider Demographics
NPI:1245906924
Name:CHILDS, HANNAH (RDN, IBCLC)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:CHILDS
Suffix:
Gender:F
Credentials:RDN, IBCLC
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:PEDDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6170 BARRETT RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80926-9506
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6170 BARRETT RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80926-9506
Practice Address - Country:US
Practice Address - Phone:719-445-9827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-21
Last Update Date:2021-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COL-302722174N00000X
CO1105751133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174N00000XOther Service ProvidersLactation Consultant, Non-RN