MD Nutrition And Lifestyle, LLC
Dietitian, Registered in Kingstowne, Virginia
1972002301- Practice location
- 5901 Kingstowne Village Pkwy, Suite 300, Kingstowne, VA 22315
- Phone
- 860-796-1930
- Fax
- —
- Last updated
- February 12, 2018
MD Nutrition And Lifestyle, LLC is a healthcare organization based in Kingstowne, VA. MD Nutrition And Lifestyle, LLC practices in Kingstowne, VA. The NPI Number for MD Nutrition And Lifestyle, LLC is 1972002301 and holds a License No. 001415 (CT). The current practice location address for MD Nutrition And Lifestyle, LLC is 5901 Kingstowne Village Pkwy, Suite 300, Kingstowne, VA 22315 and can be reached out via phone at 860-796-1930.
Provider Profile Details
- NPI Number
- 1972002301
- Provider Name
- MD Nutrition And Lifestyle, LLC
- Provider Entity Type
- Organization
- Address
- 5901 Kingstowne Village Pkwy, Suite 300, Kingstowne, VA 22315
- Phone Number
- 860-796-1930
- Primary Taxonomy
- Dietitian, Registered · 133V00000X
- Organization Subpart
- No
- Authorized Official
- Miss Mara Michele Davis, MS, RD, CDN, LPN · Clinical Dietitan · 860-796-1930
- Provider Enumeration Date
- February 12, 2018
- Last Update Date
- February 12, 2018
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 5901 Kingstowne Village Pkwy
Suite 300
Kingstowne, VA 22315 - City
- Kingstowne
- State
- Virginia
- Zip
- 22315
- Phone Number
- 860-796-1930
Provider Business Mailing Address Details
- Address
- 95 Bretton RD
Middletown, CT 06457 - City
- Middletown
- State
- CT
- Zip
- 06457
- Phone Number
- 860-796-1930
License Information
- License Number (1)
- 001415
- License State (1)
- CT
- Taxonomy (1)
- Dietitian, Registered · 133V00000X
- License Number (2)
- L002913
- License State (2)
- NC
- Taxonomy (2)
- Dietitian, Registered · 133V00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Dietitian, Registered providers near Kingstowne, VA
View all Dietitian, Registered providers in Kingstowne →Frequently Asked Questions
What is the NPI number of MD Nutrition And Lifestyle, LLC?
The NPI number of MD Nutrition And Lifestyle, LLC is 1972002301. It was assigned on February 12, 2018 and is currently active in the NPPES registry.
What is the specialty of MD Nutrition And Lifestyle, LLC?
MD Nutrition And Lifestyle, LLC is registered under the primary taxonomy Dietitian, Registered (code 133V00000X), licensed in CT under license number 001415.
Where does MD Nutrition And Lifestyle, LLC practice?
The practice location is 5901 Kingstowne Village Pkwy, Suite 300, Kingstowne, VA 22315. The office can be reached at 860-796-1930 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1972002301 directly on the NPPES registry website.