Healthcare Provider Details

I. General information

NPI: 1760323596
Provider Name (Legal Business Name): KINDLEGLOW NUTRITION PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2026
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

853 E 4680 S APT A421
MURRAY UT
84117-1607
US

IV. Provider business mailing address

1887 WHITNEY MESA DR # 5161
HENDERSON NV
89014-2069
US

V. Phone/Fax

Practice location:
  • Phone: 702-819-0368
  • Fax:
Mailing address:
  • Phone: 702-819-0368
  • 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: MEGAN JENSEN
Title or Position: OWNER
Credential: CEDS-C, MPH, RDN, CD
Phone: 702-819-0368