Provider Demographics
NPI:1881244267
Name:CAPONE, LAUREN MARIE (MSACN)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:CAPONE
Suffix:
Gender:F
Credentials:MSACN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:862 1/2 15TH ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-7624
Mailing Address - Country:US
Mailing Address - Phone:410-428-6420
Mailing Address - Fax:
Practice Address - Street 1:2260 BASELINE RD STE 102
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-7740
Practice Address - Country:US
Practice Address - Phone:720-310-5373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist