Provider Demographics
NPI:1356799183
Name:NUTRITION CONSULTANTS, INC.
Entity type:Organization
Organization Name:NUTRITION CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:GANTT
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:910-916-6855
Mailing Address - Street 1:6866 TOWBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-2534
Mailing Address - Country:US
Mailing Address - Phone:910-916-6855
Mailing Address - Fax:910-425-2985
Practice Address - Street 1:6866 TOWBRIDGE RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-2534
Practice Address - Country:US
Practice Address - Phone:910-916-6855
Practice Address - Fax:910-425-2985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000620133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1821050675OtherNPI