Provider Demographics
NPI:1720667991
Name:NOURISH WITH CLAIRE LLC
Entity Type:Organization
Organization Name:NOURISH WITH CLAIRE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARLTON
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:352-284-8244
Mailing Address - Street 1:225 KAIULANI AVE APT 904
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-3044
Mailing Address - Country:US
Mailing Address - Phone:352-284-8244
Mailing Address - Fax:
Practice Address - Street 1:225 KAIULANI AVE APT 904
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-3044
Practice Address - Country:US
Practice Address - Phone:352-284-8244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty