MEDICARE: A'S 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	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1427756691
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A'S NUTRITION LLC

Provider Business Mailing Address
First Line	:	321 WALNUT ST # 349
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02460-1927
Country	:	US
Telephone Number	:	617-527-3122
Fax Number	:	617-527-9866

Provider Business Practice Location Address
First Line	:	6 RIVER ST
Second Line	:
City	:	SOUTH EASTON
State	:	MA
Zip	:	02375-1286
Country	:	US
Telephone Number	:	617-527-3122
Fax Number	:	617-527-9866

Authorized Official
Title or Position	:	REGISTERED DIETITIAN
Name	:	KRISTIN ELLIS
Credential	:	RD, LDN
Telephone Number	:	774-219-7997

Provider Enumeration Date	:	02/17/2023
Last Update Date	:	02/17/2023

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