Provider Type Icon

KOREN H. BRADSHAW MS CLC NPI 1205308012


NPI Information

NPI: 1205308012
Provider Name: KOREN H. BRADSHAW, MS, CLC
Classification: Nutritionist - 133N00000X
Entity Type: Individual
Address:
32 ERMINE ST
FAIRFIELD, CT
ZIP 06824
Phone: (617) 827-5223
Get Directions

Koren H. Bradshaw, MS, CLC is a nutritionist in Fairfield, CT. The provider is a specialist in adapting and applying food and nutrient knowledge to the solution of food and nutritional problems, the control of disease, and the promotion of health. Nutritionists perform research, instruct groups and individuals about nutritional requirements, and assist people in developing meal patterns that meet their nutritional needs; (2) A nutritionist is someone who has completed undergraduate and/or graduate training in the discipline of nutrition without necessarily meeting the academic and experience requirements to qualify for the Registered Dietitian designation. Koren H. Bradshaw, MS, CLC NPI is 1205308012. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

32 ERMINE ST
FAIRFIELD, CT
ZIP 06824-109
Phone: (617) 827-5223

The enumeration date for this NPI number is 12/19/2018 and was last updated on 12/19/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1133NN1002XNutritionistNutrition, EducationNo
2174N00000XLactation Consultant, Non-RNNo
3133N00000XNutritionistYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.