Provider Demographics
NPI:1568060903
Name:APPLE WELLNESS AND NUTRITION CENTER. LLC
Entity Type:Organization
Organization Name:APPLE WELLNESS AND NUTRITION CENTER. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SHOBHA
Authorized Official - Middle Name:
Authorized Official - Last Name:NANDIVADA
Authorized Official - Suffix:
Authorized Official - Credentials:RD,CDE,IFNCP
Authorized Official - Phone:347-982-4372
Mailing Address - Street 1:6132 WHEATLAND RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-2762
Mailing Address - Country:US
Mailing Address - Phone:347-967-7243
Mailing Address - Fax:410-788-1086
Practice Address - Street 1:6132 WHEATLAND RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-2762
Practice Address - Country:US
Practice Address - Phone:347-967-7243
Practice Address - Fax:410-788-1086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty