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NPI Code Detail

MEDICARE: REFRESH NUTRITION INCORPORATED

MEDICARE: REFRESH NUTRITION INCORPORATED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133VN1004XPediatric Nutrition Registered Dietitian
2133VN1005XRenal Nutrition Registered Dietitian
3133VN1201XObesity and Weight Management Nutrition Registered Dietitian
4133VN1301XOncology Nutrition Registered Dietitian
5133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1306453006
Entity Type Code : Organization
Provider Name (Legal Business Name) : REFRESH NUTRITION INCORPORATED
Provider Business Mailing Address
First Line : 408 N CEDAR BLUFF RD STE 550
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-3607
Country : US
Telephone Number : 805-870-5588
Fax Number : 805-512-8522
Provider Business Practice Location Address
First Line : 408 N CEDAR BLUFF RD STE 550
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-3607
Country : US
Telephone Number : 805-870-5588
Fax Number :
Authorized Official
Title or Position : REGISTERED DIETITIAN
Name : KELLEY MAY MESA
Credential : MS, RD
Telephone Number : 805-870-5588
Provider Enumeration Date : 09/26/2020
Last Update Date : 06/08/2022

Similar Medicare Providers

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Practice Location Address:
408 N CEDAR BLUFF RD # 305
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Practice Fax:
1255820874 — MELANIE VANCE
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408 N CEDAR BLUFF RD
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Practice Fax:
1538809348 — MADISON MANGRUM BCBA
Practice Location Address:
408 N CEDAR BLUFF RD
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37923-3607
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Practice Fax: 865-888-5819
1720805120 — KELLIE ANNE KINDRICK LCSW
Practice Location Address:
408 N CEDAR BLUFF RD
KNOXVILLE, TN
37923-3607
Practice Phone: 865-268-3852
Practice Fax:
1518060136 — MRS. JOSEPHINE SWANN NODELL RN CPNC
Practice Location Address:
4529 ASHEVILLE HWY
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37914-3607
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Practice Fax: 865-522-1161
1578750733 — LAUREN BELL GAYLORD RN, CPNP
Practice Location Address:
4529 ASHEVILLE HWY
KNOXVILLE, TN
37914-3607
Practice Phone: 865-522-8114
Practice Fax: 865-522-1161

Directions to “REFRESH NUTRITION INCORPORATED ” Practice Location

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