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General NPI Number Information
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NPI Number | 1063298636
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Entity Type | Organization
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Legal Business Name | LIVE WITH NUTRITION LLC
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Dates
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Enumeration Date | 09/07/2023
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 6101 LONG PRAIRIE RD STE 752
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City | FLOWER MOUND
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State | TX
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Zip | 75028-6207
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Country | US
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Telephone | 214-276-1533
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Fax |
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Provider Business Mailing Address
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Address Line | 931 INVERNESS CIR
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City | LEWISVILLE
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State | TX
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Zip | 75077-3148
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Country | US
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Telephone | 214-924-3831
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Fax |
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Authorized Official
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Title or Position | OWNER/RD
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Name | ELIZABETH STASNY
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Credential | MCN RDN LD CNSC
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Telephone | 214-924-3831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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