NPI 1093944654 · live from the CMS NPI Registry
Kristine Noel Clark, RD, LDN
Dietitian, Registered in Rock Springs, WY. National Provider Identifier 1093944654, active.
NPI record
| NPI | 1093944654 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 1471 Dewar Dr # 204, Rock Springs, WY 82901 |
| Practice phone | 919-564-9064 |
| Mailing address | 1010 Arrowhead Cir, Rock Springs, WY 82901 |
| Enumerated | July 3, 2009 |
| Last updated | December 12, 2017 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered, Nutrition, Metabolic | 133VN1006X | 117 (WY) |
| Dietitian, Registered primary | 133V00000X | 117 (WY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.