Provider Demographics
NPI:1649893140
Name:LORELEI NUTRITION
Entity type:Organization
Organization Name:LORELEI NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRETA
Authorized Official - Middle Name:LORELEI
Authorized Official - Last Name:HENSLER
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LN, CSO
Authorized Official - Phone:406-450-1654
Mailing Address - Street 1:1112 DELPHINIUM DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-3216
Mailing Address - Country:US
Mailing Address - Phone:406-450-1654
Mailing Address - Fax:
Practice Address - Street 1:213 N BROADWAY STE 4
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1972
Practice Address - Country:US
Practice Address - Phone:406-450-1654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty