Provider Demographics
NPI:1770607699
Name:MILANO, KIM OBERIST (RD)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:OBERIST
Last Name:MILANO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:OBERIST
Other - Last Name:RICHMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:3 SAINT LO CIR
Mailing Address - Street 2:
Mailing Address - City:FORT CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913-1712
Mailing Address - Country:US
Mailing Address - Phone:719-559-5140
Mailing Address - Fax:
Practice Address - Street 1:1650 COCHRANE CIR # B7500
Practice Address - Street 2:
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4603
Practice Address - Country:US
Practice Address - Phone:719-526-7968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
R595056133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric