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General NPI Number Information
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NPI Number | 1275120438
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Entity Type | Organization
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Legal Business Name | YOUTRITION, LLC
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Dates
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Enumeration Date | 12/22/2020
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Last Update Date | 12/22/2020
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Provider Practice Location Address
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Address Line | 2424 21ST AVE S STE 201
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City | NASHVILLE
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State | TN
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Zip | 37212-5315
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Country | US
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Telephone | 615-861-9146
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Fax |
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Provider Business Mailing Address
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Address Line | 1241 OLD HICKORY BLVD
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City | BRENTWOOD
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State | TN
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Zip | 37027-4006
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Country | US
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Telephone | 615-663-3102
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBIN KATHRYN WINKLER
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Credential | RD
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Telephone | 615-663-3102
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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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