Provider Demographics
NPI:1275199085
Name:CBNUTRITION, LLC
Entity Type:Organization
Organization Name:CBNUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:NALIVKA
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:775-340-2257
Mailing Address - Street 1:PO BOX 1066
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89803-1066
Mailing Address - Country:US
Mailing Address - Phone:775-340-2257
Mailing Address - Fax:
Practice Address - Street 1:620 S 12TH ST STE 110
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-4010
Practice Address - Country:US
Practice Address - Phone:775-340-2257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty