Provider Demographics
NPI:1497088777
Name:NUTRITION PLUS OF GREENVILLE INC.
Entity Type:Organization
Organization Name:NUTRITION PLUS OF GREENVILLE INC.
Other - Org Name:NUTRITION PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LDN, CR
Authorized Official - Phone:252-758-0721
Mailing Address - Street 1:3005B S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-6224
Mailing Address - Country:US
Mailing Address - Phone:252-758-0721
Mailing Address - Fax:252-756-7845
Practice Address - Street 1:3005B S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-6224
Practice Address - Country:US
Practice Address - Phone:252-758-0721
Practice Address - Fax:252-756-7845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL001889133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty