Provider Demographics
NPI:1023839172
Name:INTUITION NUTRITION, LLC
Entity type:Organization
Organization Name:INTUITION NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:225-361-6691
Mailing Address - Street 1:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:SOMERSET CENTER
Mailing Address - State:MI
Mailing Address - Zip Code:49282-0021
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10380 RAILROAD STREET
Practice Address - Street 2:
Practice Address - City:SOMERSET CENTER
Practice Address - State:MI
Practice Address - Zip Code:49282
Practice Address - Country:US
Practice Address - Phone:225-361-6691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No251K00000XAgenciesPublic Health or WelfareGroup - Single Specialty