Healthcare Provider Details

I. General information

NPI: 1740043694
Provider Name (Legal Business Name): 307 NUTRITION CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 E 2ND ST STE 301B
CASPER WY
82601-2539
US

IV. Provider business mailing address

2143 WATERFORD
CASPER WY
82609-3300
US

V. Phone/Fax

Practice location:
  • Phone: 307-267-4545
  • Fax:
Mailing address:
  • Phone: 307-247-3526
  • 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: JENNIFER M SESLEY
Title or Position: OWNER
Credential: RD
Phone: 307-267-4545