Provider Demographics
NPI:1902172562
Name:ATNIP, LUCINDA MARIE (RDN)
Entity Type:Individual
Prefix:MRS
First Name:LUCINDA
Middle Name:MARIE
Last Name:ATNIP
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:LUCINDA
Other - Middle Name:MARIE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:5642 GREYBULL HWY
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-9618
Mailing Address - Country:US
Mailing Address - Phone:307-250-4966
Mailing Address - Fax:918-585-3047
Practice Address - Street 1:5642 GREYBULL HWY
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-9618
Practice Address - Country:US
Practice Address - Phone:307-250-4966
Practice Address - Fax:918-585-3047
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY289133V00000X
OK1798133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered