Provider Demographics
NPI:1861174849
Name:OSTROSKI, AMY LYNN (RD, CLC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:OSTROSKI
Suffix:
Gender:F
Credentials:RD, CLC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:VETTER-OSTROSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD, CLC
Mailing Address - Street 1:3361 LIVERPOOL ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-2378
Mailing Address - Country:US
Mailing Address - Phone:201-705-6587
Mailing Address - Fax:
Practice Address - Street 1:3361 LIVERPOOL ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-2378
Practice Address - Country:US
Practice Address - Phone:201-705-6587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174N00000XOther Service ProvidersLactation Consultant, Non-RN