Provider Demographics
NPI:1922576198
Name:NULEEU NUTRITION AND WELLNESS, LLC
Entity Type:Organization
Organization Name:NULEEU NUTRITION AND WELLNESS, LLC
Other - Org Name:HAMPTON ROADS NUTRITION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ETHERTON
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:757-339-3624
Mailing Address - Street 1:1517 TECHNOLOGY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-5985
Mailing Address - Country:US
Mailing Address - Phone:757-339-3624
Mailing Address - Fax:855-539-9634
Practice Address - Street 1:1545 CROSSWAYS BLVD STE 250
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-0218
Practice Address - Country:US
Practice Address - Phone:757-339-3624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-06
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1275001430OtherNPI TYPE 1
1881212959OtherNPT TYPE 1