Healthcare Provider Details

I. General information

NPI: 1780539338
Provider Name (Legal Business Name): NUTRITION A LA MESA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

743 HOYT ST
CORNELIA GA
30531-2656
US

IV. Provider business mailing address

743 HOYT ST
CORNELIA GA
30531-2656
US

V. Phone/Fax

Practice location:
  • Phone: 706-843-7439
  • Fax:
Mailing address:
  • Phone: 706-843-3749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: PALOMA VEGA
Title or Position: REGISTERED DIETITIAN
Credential: MS, RD, LD
Phone: 706-843-7439