Provider Demographics
NPI:1275195992
Name:SUNRISE NUTRITION CONSULTING LLC
Entity Type:Organization
Organization Name:SUNRISE NUTRITION CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:316-217-2984
Mailing Address - Street 1:109 E PINE ST
Mailing Address - Street 2:
Mailing Address - City:HESSTON
Mailing Address - State:KS
Mailing Address - Zip Code:67062-9055
Mailing Address - Country:US
Mailing Address - Phone:316-217-2984
Mailing Address - Fax:620-869-9032
Practice Address - Street 1:359 N OLD US HIGHWAY 81
Practice Address - Street 2:
Practice Address - City:HESSTON
Practice Address - State:KS
Practice Address - Zip Code:67062-9406
Practice Address - Country:US
Practice Address - Phone:316-217-2984
Practice Address - Fax:620-869-9032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center