Provider Demographics
NPI:1790065506
Name:NUTRITION SOLUTIONS LLC
Entity Type:Organization
Organization Name:NUTRITION SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUSH
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN, CDOE
Authorized Official - Phone:401-480-9963
Mailing Address - Street 1:46 FELICIA CT
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-3198
Mailing Address - Country:US
Mailing Address - Phone:401-480-9963
Mailing Address - Fax:
Practice Address - Street 1:198 BUTTONWOODS AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-7541
Practice Address - Country:US
Practice Address - Phone:401-480-9963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN00609133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty