Provider Demographics
NPI:1467348771
Name:CZARNECKI, ERIN (REGISTERED DIETITIAN)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:CZARNECKI
Suffix:
Gender:F
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 W VILLA RITA DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-1336
Mailing Address - Country:US
Mailing Address - Phone:509-580-0003
Mailing Address - Fax:
Practice Address - Street 1:5425 W VILLA RITA DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1336
Practice Address - Country:US
Practice Address - Phone:509-580-0003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered