Carolynn Ann Claussen, RDN, CSSD, LDN
Individual provider Active NPI Sports Dietetics Nutrition Registered Dietitian · Kirtland Afb, NM
NPI 1164210282 · NPPES record last updated Jun 24, 2025
Key facts
- NPI
- 1164210282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Sports Dietetics Nutrition Registered Dietitian 133VN1501X
- License
- 164.010524 (IL)
- Practice address
- 2050A 2ND St SE
Kirtland Afb, NM 87117-5901 - Phone
- (505) 846-3200
- NPI assigned
- Apr 28, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.010524 | IL | MD | Sports Dietetics Nutrition Registered Dietitian |
| NDP-2025-0048 | NM | MD | Sports Dietetics Nutrition Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Dietetics Nutrition Registered Dietitian | 133VN1501X | NDP-2025-0048 | NM | |
| Sports Dietetics Nutrition Registered Dietitian | 133VN1501X | 164.010524 | IL | Yes |
Addresses
Primary practice location
2050A 2ND St SE
Kirtland Afb, NM 87117-5901
Mailing address
6100 Cortaderia St NE Apt 3718
Albuquerque, NM 87111-8011
Phone (815) 871-9149
Other providers in Kirtland Afb, NM
- Benjamin H Carter
- Michael Carvajal
- Brant Evin Casteel
- Rodney Vernon Chandler
- Thomas F Clarke
- Brandon Clint
- James W Cockerill
- Sylvia Aracely Coon
- Marco Corda
- Michael Raymond Craddock
All providers in Kirtland Afb, NM · Sports Dietetics Nutrition Registered Dietitian in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.