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General NPI Number Information
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NPI Number | 1245944792
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Entity Type | Organization
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Legal Business Name | NEXTGEN NUTRITION, LLC
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Dates
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Enumeration Date | 01/10/2023
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | 2108 N ST STE N
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City | SACRAMENTO
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State | CA
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Zip | 95816-5712
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Country | US
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Telephone | 813-486-5547
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Fax |
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Provider Business Mailing Address
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Address Line | 1770 EVERGREEN ST APT 19
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City | SAN DIEGO
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State | CA
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Zip | 92106-1975
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Country | US
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Telephone | 813-486-5547
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Fax |
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Authorized Official
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Title or Position | OWNER/DIETITIAN
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Name | BROOKE ELYSE ROBINSON
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Credential | MS, RD
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Telephone | 813-486-5547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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