Provider Demographics
NPI:1588443568
Name:SMITH, BRAYDEN TAYLOR (RDN)
Entity type:Individual
Prefix:MR
First Name:BRAYDEN
Middle Name:TAYLOR
Last Name:SMITH
Suffix:
Gender:M
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702A W DRAKE RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-5521
Mailing Address - Country:US
Mailing Address - Phone:970-821-4600
Mailing Address - Fax:
Practice Address - Street 1:702A W DRAKE RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-5521
Practice Address - Country:US
Practice Address - Phone:970-821-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86254143133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered