Provider Demographics
NPI:1720092695
Name:THE NUTRITION ACCOUNTANT, LLC
Entity Type:Organization
Organization Name:THE NUTRITION ACCOUNTANT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRIE
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:HAGENHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD, CDE
Authorized Official - Phone:417-300-9679
Mailing Address - Street 1:5619 N FARM ROAD 125
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65803-6209
Mailing Address - Country:US
Mailing Address - Phone:417-300-9679
Mailing Address - Fax:
Practice Address - Street 1:5619 N FARM ROAD 125
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65803-6209
Practice Address - Country:US
Practice Address - Phone:417-300-9679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001008947133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1205833415OtherNPI USED AT HOSPITAL