Provider Demographics
NPI:1902589518
Name:PIDEK, ADRIANN LYNN (RDN)
Entity Type:Individual
Prefix:
First Name:ADRIANN
Middle Name:LYNN
Last Name:PIDEK
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9250 W 101ST PL
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3877
Mailing Address - Country:US
Mailing Address - Phone:970-388-6072
Mailing Address - Fax:
Practice Address - Street 1:9250 W 101ST PL
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-3877
Practice Address - Country:US
Practice Address - Phone:970-388-6072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO933806133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered