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NPI Code Detail

MEDICARE: MY NUTRITION MY LIFE LLC

MEDICARE: MY NUTRITION MY LIFE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianNV20101799454NV

General Provider Information

NPI Number : 1083916399
Entity Type Code : Organization
Provider Name (Legal Business Name) : MY NUTRITION MY LIFE LLC
Provider Business Mailing Address
First Line : 170 S GREEN VALLEY PKWY FL 3
Second Line :
City : HENDERSON
State : NV
Zip : 89012-3132
Country : US
Telephone Number : 702-606-3106
Fax Number : 702-534-4003
Provider Business Practice Location Address
First Line : 170 S GREEN VALLEY PKWY FL 3
Second Line :
City : HENDERSON
State : NV
Zip : 89012-3132
Country : US
Telephone Number : 702-606-3106
Fax Number : 702-534-4003
Authorized Official
Title or Position : OWNER
Name : KAMALINI MUKERJEE
Credential : RD
Telephone Number : 702-606-3106
Provider Enumeration Date : 11/19/2010
Last Update Date : 07/21/2022

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Directions to “MY NUTRITION MY LIFE LLC ” Practice Location

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