MEDICARE: ISCRIPT NUTRITION 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
1	133N00000X	Nutritionist

General Provider Information

NPI Number	:	1427667039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISCRIPT NUTRITION LLC

Provider Business Mailing Address
First Line	:	212 N 2ND ST STE 100
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-1408
Country	:	US
Telephone Number	:	859-363-5945
Fax Number	:

Provider Business Practice Location Address
First Line	:	212 N 2ND ST STE 100
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-1408
Country	:	US
Telephone Number	:	859-363-5945
Fax Number	:

Authorized Official
Title or Position	:	CEO/NUTRITIONIST
Name	:	MS. ANN MARIE MUSICK
Credential	:	CN
Telephone Number	:	937-776-5328

Provider Enumeration Date	:	07/29/2020
Last Update Date	:	07/29/2020

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