Provider Demographics
NPI:1184013054
Name:SVELTE LLC
Entity Type:Organization
Organization Name:SVELTE LLC
Other - Org Name:FIT MEDICAL WEIGHT LOSS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:NYMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-400-3889
Mailing Address - Street 1:4011 BARBARA LOOP SE STE 108
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-1040
Mailing Address - Country:US
Mailing Address - Phone:505-400-3889
Mailing Address - Fax:505-896-4738
Practice Address - Street 1:4011 BARBARA LOOP SE STE 108
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1040
Practice Address - Country:US
Practice Address - Phone:505-400-3889
Practice Address - Fax:505-896-4738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-15
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty