Provider Demographics
NPI:1477921427
Name:INSIGHT NUTRITION
Entity Type:Organization
Organization Name:INSIGHT NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOJANG
Authorized Official - Suffix:
Authorized Official - Credentials:MFCS, RD, LDN
Authorized Official - Phone:469-690-0085
Mailing Address - Street 1:8950 BRIDLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-3534
Mailing Address - Country:US
Mailing Address - Phone:901-921-1909
Mailing Address - Fax:
Practice Address - Street 1:3521 WILSHIRE WAY APT 1151
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-0074
Practice Address - Country:US
Practice Address - Phone:469-690-0085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-08
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2885133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty