Provider Demographics
NPI:1710625843
Name:CLARIFIED NUTRITION LLC
Entity Type:Organization
Organization Name:CLARIFIED NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, REGISTERED DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:MCCASLIN
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN, LD
Authorized Official - Phone:913-303-9367
Mailing Address - Street 1:9307 DEARBORN ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66207-2421
Mailing Address - Country:US
Mailing Address - Phone:913-303-9367
Mailing Address - Fax:913-303-9367
Practice Address - Street 1:9307 DEARBORN ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66207-2421
Practice Address - Country:US
Practice Address - Phone:913-303-9367
Practice Address - Fax:913-303-9367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty