Provider Demographics
NPI:1881312809
Name:FEHR, EMMA RAE (RD)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:RAE
Last Name:FEHR
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:RAE
Other - Last Name:THATCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23305 COUNTY ROAD 22
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:CO
Mailing Address - Zip Code:80642-9512
Mailing Address - Country:US
Mailing Address - Phone:515-890-8507
Mailing Address - Fax:
Practice Address - Street 1:23305 COUNTY ROAD 22
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:CO
Practice Address - Zip Code:80642-9512
Practice Address - Country:US
Practice Address - Phone:515-890-8507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86293705133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered