Healthcare Provider Details

I. General information

NPI: 1447189063
Provider Name (Legal Business Name): KINFOLK NUTRITION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4258 TALMADGE CIR
CAMP SPRINGS MD
20746-4273
US

IV. Provider business mailing address

10770 COLUMBIA PIKE STE 300, #1227
SILVER SPRING MD
20901-4439
US

V. Phone/Fax

Practice location:
  • Phone: 720-550-4204
  • Fax:
Mailing address:
  • Phone: 720-550-4204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: EMMA GARDNER
Title or Position: FOUNDER
Credential: CNS, LDN, LN
Phone: 720-550-4204