Provider Demographics
NPI:1609267020
Name:BE HEALTHY BY NATURE
Entity Type:Organization
Organization Name:BE HEALTHY BY NATURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED DIETICIAN/NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DRPH, MS, LDN
Authorized Official - Phone:240-334-6172
Mailing Address - Street 1:9701 APOLLO DR STE 301
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-4790
Mailing Address - Country:US
Mailing Address - Phone:240-334-6171
Mailing Address - Fax:240-334-4848
Practice Address - Street 1:9701 APOLLO DR STE 301
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-4790
Practice Address - Country:US
Practice Address - Phone:240-334-6171
Practice Address - Fax:240-334-4848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX3170133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty