MEDICARE: LANA COXTON NUTRITION LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	133N00000X	Nutritionist
2	133NN1002X	Nutrition Education Nutritionist
3	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1801450085
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANA COXTON NUTRITION LLC

Provider Business Mailing Address
First Line	:	PO BOX 1692
Second Line	:
City	:	BELLEVILLE
State	:	MI
Zip	:	48112-1692
Country	:	US
Telephone Number	:	313-318-7612
Fax Number	:

Provider Business Practice Location Address
First Line	:	23077 GREENFIELD RD STE 479
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48075-3769
Country	:	US
Telephone Number	:	313-318-7612
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MS. LANA K COXTON
Credential	:	RD
Telephone Number	:	313-318-7612

Provider Enumeration Date	:	04/23/2019
Last Update Date	:	04/23/2019

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Directions to “LANA COXTON NUTRITION LLC ” Practice Location

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