Healthcare Provider Details

I. General information

NPI: 1801651336
Provider Name (Legal Business Name): NUTRIENT RICH LIFE NUTRITION COACHING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5155 BUEHLERS DR STE 102
MEDINA OH
44256-5389
US

IV. Provider business mailing address

195 SOMERSET DR
HINCKLEY OH
44233-9655
US

V. Phone/Fax

Practice location:
  • Phone: 330-441-1706
  • Fax:
Mailing address:
  • Phone:
  • 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: DIANA HILTON
Title or Position: CREDENTIALING
Credential:
Phone: 863-443-2204