Provider Demographics
NPI:1316682826
Name:LEMKE, DANA (RD)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:LEMKE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 BATTLECREEK DR APT 15208
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-6223
Mailing Address - Country:US
Mailing Address - Phone:206-503-0212
Mailing Address - Fax:
Practice Address - Street 1:825 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-6169
Practice Address - Country:US
Practice Address - Phone:720-252-9415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86117750133VN1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics