Provider Demographics
NPI:1457134025
Name:NUTRITION DIGESTED, LLC
Entity Type:Organization
Organization Name:NUTRITION DIGESTED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD
Authorized Official - Phone:203-558-1425
Mailing Address - Street 1:6300 SAGEWOOD DR STE H433
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-7502
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:421 62ND ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1312
Practice Address - Country:US
Practice Address - Phone:203-558-1425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-16
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty