Individual
MRS. KIMBERLY GARRETT WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD, CDE
Contact information
Practice address
3519 RICHMOND DR, FORT COLLINS, CO 80526-5995
(970) 204-0300
(970) 226-9041
Mailing address
3519 RICHMOND DR, FORT COLLINS, CO 80526-5995
(970) 204-0300
(970) 226-9041
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
187347
CERTIFIED DIABETES EDUCATOR
CO
01
—
632685
ADA REGISTERED DIETITIAN
—
01
—
DT80452
TEXAS DIETITIAN LICENSE
TX
Enumeration date
06/15/2007
Last updated
02/28/2014
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