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General NPI Number Information
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NPI Number | 1801617378
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Entity Type | Organization
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Legal Business Name | FOOD COACH ME LLC
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 5505 FOXRIDGE DR STE 105
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City | MISSION
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State | KS
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Zip | 66202-1556
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Country | US
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Telephone | 913-717-9948
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Fax | 913-382-7434
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Provider Business Mailing Address
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Address Line | 5505 FOXRIDGE DR STE 105
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City | MISSION
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State | KS
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Zip | 66202-1556
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Country | US
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Telephone | 405-623-3399
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Fax | 913-382-7434
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Authorized Official
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Title or Position | REGISTERED DIETITIAN
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Name | STEPHANIE WAGNER
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Credential | MS, RDN
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Telephone | 405-623-3399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number |
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License Number State |
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