Provider Demographics
NPI:1164204087
Name:WHOLESOME AND HEALTHY WITH HANNAH, LLC
Entity Type:Organization
Organization Name:WHOLESOME AND HEALTHY WITH HANNAH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:KUBISCH
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:615-775-7964
Mailing Address - Street 1:6628 N CREEKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7839
Mailing Address - Country:US
Mailing Address - Phone:615-775-7964
Mailing Address - Fax:
Practice Address - Street 1:6628 N CREEKWOOD DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7839
Practice Address - Country:US
Practice Address - Phone:615-775-7964
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty