Provider Demographics
NPI:1790012037
Name:ALL ABOUT NUTRITION LLC
Entity Type:Organization
Organization Name:ALL ABOUT NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:DINEEN
Authorized Official - Last Name:KEMP
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:215-464-3004
Mailing Address - Street 1:534 W MIDVALE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-4618
Mailing Address - Country:US
Mailing Address - Phone:215-464-3004
Mailing Address - Fax:215-438-2731
Practice Address - Street 1:3330 GRANT AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-2600
Practice Address - Country:US
Practice Address - Phone:215-464-3004
Practice Address - Fax:215-464-7638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-06
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA949149133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty