Healthcare Provider Details

I. General information

NPI: 1831002351
Provider Name (Legal Business Name): RUN WHOLE NUTRITION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3499 BLAZER PKWY
LEXINGTON KY
40509-2798
US

IV. Provider business mailing address

3499 BLAZER PKWY STE 330
LEXINGTON KY
40509-2828
US

V. Phone/Fax

Practice location:
  • Phone: 859-951-6023
  • Fax: 859-787-0519
Mailing address:
  • Phone: 859-951-6023
  • Fax: 859-787-0519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MEGAN MEDRANO
Title or Position: DIETITIAN, OWNER
Credential: RD, LD, CEDS
Phone: 859-951-6023