Provider Demographics
NPI:1285196477
Name:NUTRITION PRESCRIPTIONS LLC
Entity Type:Organization
Organization Name:NUTRITION PRESCRIPTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AUTHORIZED USER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YAQUTULLAH
Authorized Official - Middle Name:IBRAHEEM
Authorized Official - Last Name:MUHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN, LD
Authorized Official - Phone:404-454-7356
Mailing Address - Street 1:2670 MIRIAM LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-5731
Mailing Address - Country:US
Mailing Address - Phone:404-454-7356
Mailing Address - Fax:404-601-9775
Practice Address - Street 1:2670 MIRIAM LN
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-5731
Practice Address - Country:US
Practice Address - Phone:404-454-7356
Practice Address - Fax:404-601-9775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-05
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No305R00000XManaged Care OrganizationsPreferred Provider OrganizationGroup - Multi-Specialty