Provider Demographics
NPI:1902415516
Name:NUTRITION PATHWAYS LLC
Entity Type:Organization
Organization Name:NUTRITION PATHWAYS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, RD
Authorized Official - Phone:310-500-9492
Mailing Address - Street 1:923 OLDHAM DR UNIT 1196
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-7532
Mailing Address - Country:US
Mailing Address - Phone:310-500-9492
Mailing Address - Fax:
Practice Address - Street 1:210 MUIR AVE
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-1639
Practice Address - Country:US
Practice Address - Phone:310-500-9492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty