Provider Demographics
NPI:1437959897
Name:PAGE, CARA JANE (MDA, RDN)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:JANE
Last Name:PAGE
Suffix:
Gender:
Credentials:MDA, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9549 S MUMFORD DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-3747
Mailing Address - Country:US
Mailing Address - Phone:801-641-5966
Mailing Address - Fax:
Practice Address - Street 1:9549 S MUMFORD DR UNIT A
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-3747
Practice Address - Country:US
Practice Address - Phone:801-641-5966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-15
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14180927-4901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered