Provider Demographics
NPI:1477224772
Name:PLANT HEALTHY HABITS LLC
Entity Type:Organization
Organization Name:PLANT HEALTHY HABITS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:NYKAZA
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, CD
Authorized Official - Phone:414-420-9419
Mailing Address - Street 1:10425 W NORTH AVE STE 312
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-2416
Mailing Address - Country:US
Mailing Address - Phone:414-420-9419
Mailing Address - Fax:
Practice Address - Street 1:10425 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-2416
Practice Address - Country:US
Practice Address - Phone:414-420-9419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-26
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty