Provider Demographics
NPI:1639685183
Name:BE BOLD NUTRITION, LLC
Entity Type:Organization
Organization Name:BE BOLD NUTRITION, LLC
Other - Org Name:NUTRITION OF NASHVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LDN
Authorized Official - Phone:615-988-4255
Mailing Address - Street 1:2021 RICHARD JONES RD STE 350B
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2871
Mailing Address - Country:US
Mailing Address - Phone:615-988-4255
Mailing Address - Fax:888-972-1886
Practice Address - Street 1:2021 RICHARD JONES RD STE 350B
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215
Practice Address - Country:US
Practice Address - Phone:615-988-4255
Practice Address - Fax:888-972-1886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-20
Last Update Date:2019-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1035133N00000X
IL875997133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty