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General NPI Number Information
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NPI Number | 1871392795
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Entity Type | Organization
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Legal Business Name | ROSS NUTRITION PLLC
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 2111 GENESEE ST
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City | UTICA
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State | NY
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Zip | 13501-5942
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Country | US
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Telephone | 877-510-5562
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Fax |
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Provider Business Mailing Address
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Address Line | 7026 DATE PALM LN
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City | ELLENTON
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State | FL
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Zip | 34222-4316
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Country | US
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Telephone | 941-234-4541
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Fax | 941-213-5822
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Authorized Official
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Title or Position | DOCTOR OF CLINICAL NUTRITION
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Name | DR. KIM ROSS
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Credential | DCN, CNS, LDN
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Telephone | 941-234-4541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #3
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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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