Provider Demographics
NPI:1346019932
Name:HERHEALTH NUTRITION
Entity Type:Organization
Organization Name:HERHEALTH NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:LILLY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:WHITLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD
Authorized Official - Phone:502-558-7054
Mailing Address - Street 1:163 WOODWIND CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT WASHINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40047-6881
Mailing Address - Country:US
Mailing Address - Phone:502-558-7054
Mailing Address - Fax:
Practice Address - Street 1:163 WOODWIND CT
Practice Address - Street 2:
Practice Address - City:MOUNT WASHINGTON
Practice Address - State:KY
Practice Address - Zip Code:40047-6881
Practice Address - Country:US
Practice Address - Phone:502-558-7054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-25
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty