Healthcare Provider Details

I. General information

NPI: 1689146771
Provider Name (Legal Business Name): NUTRITION THYME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2018
Last Update Date: 06/25/2023
Certification Date: 06/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RICHMOND SQUARE SUITE 333W
PROVIDENCE RI
02906-5012
US

IV. Provider business mailing address

1 RICHMOND SQUARE SUITE 333W
PROVIDENCE RI
02906
US

V. Phone/Fax

Practice location:
  • Phone: 401-855-6933
  • Fax:
Mailing address:
  • Phone: 401-855-6933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICOLE ARRUDA
Title or Position: MANAGER/OWNER
Credential: RD LDN
Phone: 401-855-6933