Provider Demographics
NPI:1750175923
Name:BOUWMAN, REBECCA ANN (RDN, NBC-HWC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:BOUWMAN
Suffix:
Gender:
Credentials:RDN, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 LEWIS DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-5725
Mailing Address - Country:US
Mailing Address - Phone:612-845-9535
Mailing Address - Fax:
Practice Address - Street 1:830 LEWIS DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-5725
Practice Address - Country:US
Practice Address - Phone:612-845-9535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No171400000XOther Service ProvidersHealth & Wellness Coach