Provider Demographics
NPI:1366636383
Name:SMART NUTRITION BY KAREN GRAHAM, RD
Entity Type:Organization
Organization Name:SMART NUTRITION BY KAREN GRAHAM, RD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:480-659-0748
Mailing Address - Street 1:7061 E. MCDONALD DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85253
Mailing Address - Country:US
Mailing Address - Phone:480-659-0748
Mailing Address - Fax:480-699-8937
Practice Address - Street 1:7061 E MCDONALD DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85253-5328
Practice Address - Country:US
Practice Address - Phone:480-659-0748
Practice Address - Fax:480-699-8937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-03
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty