Provider Demographics
NPI:1508101858
Name:NUTRITION CONNECTION LLC
Entity Type:Organization
Organization Name:NUTRITION CONNECTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:775-360-6500
Mailing Address - Street 1:675 SIERRA ROSE DR
Mailing Address - Street 2:STE. 108
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2364
Mailing Address - Country:US
Mailing Address - Phone:775-360-6500
Mailing Address - Fax:
Practice Address - Street 1:675 SIERRA ROSE DR
Practice Address - Street 2:STE. 108
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2364
Practice Address - Country:US
Practice Address - Phone:775-360-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty