Individual
KAITLYN RAE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
7717 IVY LANE, WELLINGTON, CO 80549-8054
(307) 746-8353
Mailing address
PO BOX 708, WELLINGTON, CO 80549-0708
(307) 746-8353
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86017688
CO
Other
Enumeration date
09/01/2020
Last updated
12/22/2021
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