Healthcare Provider Details

I. General information

NPI: 1023828829
Provider Name (Legal Business Name): NEW HORIZON NUTRITION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13437 EMERALD CRYSTAL DR
EL PASO TX
79928-2361
US

IV. Provider business mailing address

13437 EMERALD CRYSTAL DR
EL PASO TX
79928-2361
US

V. Phone/Fax

Practice location:
  • Phone: 612-842-9230
  • Fax:
Mailing address:
  • Phone: 612-842-9230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: DANIRABE LOWRY
Title or Position: REGISTERED DIETITIAN - OWNER
Credential: RD
Phone: 612-842-9230