Provider Demographics
NPI:1215727037
Name:REDEMPTIVE NUTRITION, LLC
Entity type:Organization
Organization Name:REDEMPTIVE NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:PAIGE
Authorized Official - Last Name:WHITMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-879-5098
Mailing Address - Street 1:815 S 38TH STREET CT APT 1
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-3576
Mailing Address - Country:US
Mailing Address - Phone:402-879-5098
Mailing Address - Fax:
Practice Address - Street 1:815 S 38TH STREET CT APT 1
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-3576
Practice Address - Country:US
Practice Address - Phone:402-879-5098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-07
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty