Provider Demographics
NPI:1801450085
Name:LANA COXTON NUTRITION LLC
Entity type:Organization
Organization Name:LANA COXTON NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LANA
Authorized Official - Middle Name:K
Authorized Official - Last Name:COXTON
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:313-318-7612
Mailing Address - Street 1:PO BOX 1692
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48112-1692
Mailing Address - Country:US
Mailing Address - Phone:313-318-7612
Mailing Address - Fax:
Practice Address - Street 1:23077 GREENFIELD RD STE 479
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3769
Practice Address - Country:US
Practice Address - Phone:313-318-7612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty