Provider Demographics
NPI:1508683418
Name:NOVAURA NUTRITION
Entity type:Organization
Organization Name:NOVAURA NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FE
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:425-835-9005
Mailing Address - Street 1:5324 RIDGEFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-2110
Mailing Address - Country:US
Mailing Address - Phone:425-835-9005
Mailing Address - Fax:
Practice Address - Street 1:5324 RIDGEFIELD AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-2110
Practice Address - Country:US
Practice Address - Phone:425-835-9005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty