Provider Demographics
NPI:1356631089
Name:ESSENTIAL NUTRITION AND WELLNESS, LLC
Entity Type:Organization
Organization Name:ESSENTIAL NUTRITION AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NUTRITIONIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KAY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SCHLEGEL-PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LDN
Authorized Official - Phone:919-923-6874
Mailing Address - Street 1:1305 WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-3030
Mailing Address - Country:US
Mailing Address - Phone:919-923-6874
Mailing Address - Fax:919-237-9214
Practice Address - Street 1:1829 E FRANKLIN ST
Practice Address - Street 2:SUITE 1200A
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5861
Practice Address - Country:US
Practice Address - Phone:919-923-6874
Practice Address - Fax:919-237-9214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC000332133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty