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General NPI Number Information
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NPI Number | 1548744485
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Entity Type | Organization
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Legal Business Name | NUTRITION EDUCATION SPECIALISTS LLC
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Dates
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Enumeration Date | 09/17/2018
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Last Update Date | 09/17/2018
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Provider Practice Location Address
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Address Line | 9009 S 14TH WAY
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City | PHOENIX
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State | AZ
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Zip | 85042-7983
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Country | US
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Telephone | 833-366-3338
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Fax |
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Provider Business Mailing Address
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Address Line | 530 E MCDOWELL RD # 107-488
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City | PHOENIX
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State | AZ
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Zip | 85004-1549
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Country | US
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Telephone | 883-366-3338
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Fax | 833-450-5557
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Authorized Official
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Title or Position | CEO
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Name | KELLY R ROBERS
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Credential | RD
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Telephone | 833-366-3338
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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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