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NPI Code Detail

MEDICARE: INTEGRATIVE NUTRITION AND WELLNESS, LLC

MEDICARE: INTEGRATIVE NUTRITION AND WELLNESS, 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
1133VN1006XMetabolic Nutrition Registered Dietitian
2133NN1002XNutrition Education Nutritionist
3133VN1201XObesity and Weight Management Nutrition Registered Dietitian
4133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1871320705
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTEGRATIVE NUTRITION AND WELLNESS, LLC
Provider Business Mailing Address
First Line : 2908 SCUPPERNONG LN
Second Line :
City : DURHAM
State : NC
Zip : 27703-9263
Country : US
Telephone Number : 919-793-8994
Fax Number :
Provider Business Practice Location Address
First Line : 5109 BUR OAK CIR STE 103
Second Line :
City : RALEIGH
State : NC
Zip : 27612-3101
Country : US
Telephone Number : 919-907-0995
Fax Number : 919-386-4177
Authorized Official
Title or Position : OWNER
Name : BRANDI CROSSON
Credential : MS, RD, LDN
Telephone Number : 919-793-8994
Provider Enumeration Date : 09/16/2024
Last Update Date : 12/17/2025

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Directions to “INTEGRATIVE NUTRITION AND WELLNESS, LLC ” Practice Location

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