Provider Demographics
NPI:1851061246
Name:TAYLORING NUTRITION, LLC
Entity Type:Organization
Organization Name:TAYLORING NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:K
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:850-529-5290
Mailing Address - Street 1:6293 CALLE DE HIDALGO
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-8927
Mailing Address - Country:US
Mailing Address - Phone:850-529-5290
Mailing Address - Fax:
Practice Address - Street 1:2220 GLORIA CIR APT 90
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-5343
Practice Address - Country:US
Practice Address - Phone:850-529-5290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty