Provider Demographics
NPI:1487406245
Name:FLANNIGAN, CADEN BRIANNE (RD, LD, CCTD)
Entity type:Individual
Prefix:
First Name:CADEN
Middle Name:BRIANNE
Last Name:FLANNIGAN
Suffix:
Gender:F
Credentials:RD, LD, CCTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5509 ROSSLYN AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-3342
Mailing Address - Country:US
Mailing Address - Phone:812-240-7366
Mailing Address - Fax:
Practice Address - Street 1:5509 ROSSLYN AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-3342
Practice Address - Country:US
Practice Address - Phone:812-240-7366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN86087074133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered