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General NPI Number Information
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NPI Number | 1629318696
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Entity Type | Organization
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Legal Business Name | RENU NUTRITION CONSULTANTS LLC
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Dates
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Enumeration Date | 02/27/2013
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 12745 S. SAGINAW RD. SUITE 806-177
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City | GRAND BLANC
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State | MI
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Zip | 48439-2437
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Country | US
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Telephone | 810-923-5600
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Fax | 810-396-6882
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Provider Business Mailing Address
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Address Line | 12745 S. SAGINAW RD. SUITE 806-177
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City | GRAND BLANC
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State | MI
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Zip | 48439-2437
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Country | US
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Telephone | 810-923-5600
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Fax | 810-396-6882
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MELISSA DAWN PIEPER
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Credential | MBA, RD, CSR
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Telephone | 810-923-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1005X
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Taxonomy Name | Renal Nutrition Registered Dietitian
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License Number | 888931
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 888931
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License Number State | MI
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