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General NPI Number Information
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NPI Number | 1346103157
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Entity Type | Organization
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Legal Business Name | 4 CANCER NUTRITION LLC
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 1407 STATE ROUTE 89
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City | ASHLAND
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State | OH
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Zip | 44805-9763
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Country | US
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Telephone | 937-269-5397
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Fax |
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Provider Business Mailing Address
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Address Line | 1407 STATE ROUTE 89
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City | ASHLAND
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State | OH
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Zip | 44805-9763
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Country | US
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Telephone | 937-269-5397
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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 | KELLY NELSON
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Credential | MS RD CSO LD
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Telephone | 937-269-5397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1301X
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Taxonomy Name | Oncology Nutrition Registered Dietitian
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License Number |
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License Number State |
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