1730129511 NPI number — MRS. MARY ANN ELIZABETH SAUSSOTTE MS, RD, CNSD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730129511 NPI number — MRS. MARY ANN ELIZABETH SAUSSOTTE MS, RD, CNSD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAUSSOTTE
Provider First Name:
MARY ANN
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS, RD, CNSD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EVANS
Provider Other First Name:
MARY ANN
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, RD, CNSD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730129511
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
265 S BUCHANAN CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80027-9526
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-216-1098
Provider Business Mailing Address Fax Number:
303-665-9601

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 EXEMPLA CIR
Provider Second Line Business Practice Location Address:
EXEMPLA GOOD SAMARITAN: HHC
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80026-3370
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-689-6580
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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