Provider Demographics
NPI:1407332356
Name:CHELSEA EDWARDS NUTRITION LLC
Entity Type:Organization
Organization Name:CHELSEA EDWARDS NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LD
Authorized Official - Phone:256-783-9530
Mailing Address - Street 1:7738B MADISON BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-3661
Mailing Address - Country:US
Mailing Address - Phone:256-224-1665
Mailing Address - Fax:833-629-8753
Practice Address - Street 1:7738B MADISON BLVD STE 204
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806
Practice Address - Country:US
Practice Address - Phone:256-224-1665
Practice Address - Fax:833-629-8753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-13
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2822133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty