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General NPI Number Information
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NPI Number | 1013578921
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Entity Type | Organization
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Legal Business Name | FUELED & FED NUTRITION
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Dates
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Enumeration Date | 06/23/2019
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 209 MADISON ST STE 320B
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City | ALEXANDRIA
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State | VA
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Zip | 22314-1764
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Country | US
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Telephone | 872-529-6420
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Fax | 703-215-3078
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Provider Business Mailing Address
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Address Line | 349 S PICKETT ST
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City | ALEXANDRIA
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State | VA
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Zip | 22304-4747
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Country | US
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Telephone | 412-527-3323
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Fax |
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Authorized Official
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Title or Position | OWNER/NUTRITIONIST
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Name | ALISHA TEMPLES
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Credential | MPH, LDN
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Telephone | 872-529-6420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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