Provider Demographics
NPI:1891274452
Name:ENLIGHTEN NUTRITION & WELLNESS, LLC
Entity Type:Organization
Organization Name:ENLIGHTEN NUTRITION & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & CEO
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:POUDRIER
Authorized Official - Last Name:NORMANDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-707-2169
Mailing Address - Street 1:233 STARK ST
Mailing Address - Street 2:
Mailing Address - City:GILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03249-6437
Mailing Address - Country:US
Mailing Address - Phone:603-707-2169
Mailing Address - Fax:
Practice Address - Street 1:152 COLBY ST
Practice Address - Street 2:
Practice Address - City:COLEBROOK
Practice Address - State:NH
Practice Address - Zip Code:03576-3049
Practice Address - Country:US
Practice Address - Phone:603-707-2169
Practice Address - Fax:833-734-1554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-14
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty