Provider Demographics
NPI:1417840018
Name:OBRIAN, GINA RAE (RDN)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:RAE
Last Name:OBRIAN
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 1:3225 W HAYWARD PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3719
Mailing Address - Country:US
Mailing Address - Phone:720-320-6631
Mailing Address - Fax:
Practice Address - Street 1:3225 W HAYWARD PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3719
Practice Address - Country:US
Practice Address - Phone:720-320-6631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered