Provider Demographics
NPI:1710238357
Name:HIPPLE, CAROL-ANNE (RD, LD, MS, MBA)
Entity type:Individual
Prefix:
First Name:CAROL-ANNE
Middle Name:
Last Name:HIPPLE
Suffix:
Gender:F
Credentials:RD, LD, MS, MBA
Other - Prefix:
Other - First Name:CAROL-ANNE
Other - Middle Name:
Other - Last Name:CARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9662 OTTER WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-5810
Mailing Address - Country:US
Mailing Address - Phone:719-425-8960
Mailing Address - Fax:
Practice Address - Street 1:9662 OTTER WAY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5810
Practice Address - Country:US
Practice Address - Phone:480-580-6551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-23
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT90217133V00000X
MO2014007459133V00000X
NV40580-DIE-0133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered