Individual
MRS. CAROLYN SUZANNE JOHANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDE, CD
Contact information
Practice address
20 S MAIN ST, BARRE, VT 05641-4826
(802) 476-7607
(802) 244-4122
Mailing address
19 WINDRIDGE LN, WATERBURY, VT 05676-9135
(802) 244-4122
(802) 244-4122
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
074-0000070
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007165
—
VT
01
—
28597
BLUE CROSS BLUE SHIELD NU
VT
01
—
47689
MVP NUMBER
VT
01
—
GREE 29429
BCBS GREEN MT NUTRITRION
VT
Enumeration date
02/17/2007
Last updated
07/09/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us