MEDICARE: SAMANTHA TURNER 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	:	1487317202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMANTHA TURNER NUTRITION, LLC

Provider Business Mailing Address
First Line	:	80 STONECREST DR
Second Line	:
City	:	BASSETT
State	:	VA
Zip	:	24055-3702
Country	:	US
Telephone Number	:	276-358-2448
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 E CHURCH ST STE 304
Second Line	:
City	:	MARTINSVILLE
State	:	VA
Zip	:	24112-6208
Country	:	US
Telephone Number	:	276-358-2448
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ LEAD REGISTERED DIETITIAN
Name	:	SAMANTHA TURNER
Credential	:	MPH, RDN, CHES
Telephone Number	:	276-358-2448

Provider Enumeration Date	:	10/19/2021
Last Update Date	:	11/29/2022

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