Provider Demographics
NPI:1356197792
Name:GREENLEAF NUTRITION CONSULTING LLC
Entity type:Organization
Organization Name:GREENLEAF NUTRITION CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENLEAF
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:785-335-9107
Mailing Address - Street 1:2705 WOODROW CT
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-1618
Mailing Address - Country:US
Mailing Address - Phone:785-335-9107
Mailing Address - Fax:785-536-6544
Practice Address - Street 1:2705 WOODROW CT
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-1618
Practice Address - Country:US
Practice Address - Phone:785-335-9107
Practice Address - Fax:785-536-6544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty