Healthcare Provider Details

I. General information

NPI: 1518476811
Provider Name (Legal Business Name): INTUIT NUTRITION & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2017
Last Update Date: 09/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 DUMAINE ST APT 7
NEW ORLEANS LA
70119-3844
US

IV. Provider business mailing address

3515 DUMAINE ST APT 7
NEW ORLEANS LA
70119-3844
US

V. Phone/Fax

Practice location:
  • Phone: 15127710315
  • Fax:
Mailing address:
  • Phone: 15127710315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number2798
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2798
License Number StateLA

VIII. Authorized Official

Name: EMILY M VAN ECK
Title or Position: REGISTERED DIETITIAN AND FOUNDER
Credential: MS, RD, LDN
Phone: 512-771-0315