Provider Demographics
NPI:1841692928
Name:YOUNG, ELLIANA BUDET (NUTRITION SPECIALIST)
Entity type:Individual
Prefix:MRS
First Name:ELLIANA
Middle Name:BUDET
Last Name:YOUNG
Suffix:
Gender:F
Credentials:NUTRITION SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7243B JASPER CT
Mailing Address - Street 2:
Mailing Address - City:FORT STEWART
Mailing Address - State:GA
Mailing Address - Zip Code:31315-1966
Mailing Address - Country:US
Mailing Address - Phone:404-232-5272
Mailing Address - Fax:
Practice Address - Street 1:7243B JASPER CT
Practice Address - Street 2:
Practice Address - City:FORT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31315-1966
Practice Address - Country:US
Practice Address - Phone:404-232-5272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-21
Last Update Date:2014-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education