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General NPI Number Information
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NPI Number | 1073452801
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Entity Type | Organization
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Legal Business Name | PURA VIDA NUTRITION LLC
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 319 BALA TER W
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City | WEST CHESTER
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State | PA
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Zip | 19380-1139
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Country | US
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Telephone | 610-470-5246
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Fax |
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Provider Business Mailing Address
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Address Line | 319 BALA TER W
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City | WEST CHESTER
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State | PA
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Zip | 19380-1139
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Country | US
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Telephone | 610-470-5246
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ZENA DUCKETT
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Credential | MA, RDN, LDN, CDCES
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Telephone | 610-470-5246
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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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