Provider Demographics
NPI:1912706474
Name:WORDEN, MARCELINA ELISE (RDN)
Entity type:Individual
Prefix:
First Name:MARCELINA
Middle Name:ELISE
Last Name:WORDEN
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4331 E MEXICO AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4105
Mailing Address - Country:US
Mailing Address - Phone:262-389-2127
Mailing Address - Fax:
Practice Address - Street 1:4331 E MEXICO AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4105
Practice Address - Country:US
Practice Address - Phone:262-389-2127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86331174133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered