=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487317202
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAMANTHA TURNER NUTRITION, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/19/2021
-----------------------------------------------------
Last Update Date | 06/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1901 PATRICK HENRY AVE STE 124
-----------------------------------------------------
City | MARTINSVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24112-3954
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 276-358-2448
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 80 STONECREST DR
-----------------------------------------------------
City | BASSETT
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24055-3702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 276-358-2448
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SAMANTHA TURNER
-----------------------------------------------------
Credential | RD
-----------------------------------------------------
Telephone | 276-226-4107
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------