Provider Demographics
NPI:1255110813
Name:NUTRITIONAL ASCENT
Entity type:Organization
Organization Name:NUTRITIONAL ASCENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LLAURY-MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-621-6948
Mailing Address - Street 1:9235 S REDWASH RD
Mailing Address - Street 2:
Mailing Address - City:JENSEN
Mailing Address - State:UT
Mailing Address - Zip Code:84035
Mailing Address - Country:US
Mailing Address - Phone:844-233-1888
Mailing Address - Fax:
Practice Address - Street 1:9235 S REDWASH RD
Practice Address - Street 2:
Practice Address - City:JENSEN
Practice Address - State:UT
Practice Address - Zip Code:84035
Practice Address - Country:US
Practice Address - Phone:844-233-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty