Provider Demographics
NPI:1801617378
Name:FOOD COACH ME LLC
Entity type:Organization
Organization Name:FOOD COACH ME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN
Authorized Official - Phone:913-717-9948
Mailing Address - Street 1:5505 FOXRIDGE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-1556
Mailing Address - Country:US
Mailing Address - Phone:913-717-9948
Mailing Address - Fax:913-382-7434
Practice Address - Street 1:5505 FOXRIDGE DR STE 105
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-1556
Practice Address - Country:US
Practice Address - Phone:913-717-9948
Practice Address - Fax:913-382-7434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Single Specialty