Provider Demographics
NPI:1063298636
Name:LIVE WITH NUTRITION LLC
Entity type:Organization
Organization Name:LIVE WITH NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/RD
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:STASNY
Authorized Official - Suffix:
Authorized Official - Credentials:MCN RDN LD CNSC
Authorized Official - Phone:214-924-3831
Mailing Address - Street 1:931 INVERNESS CIR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-3148
Mailing Address - Country:US
Mailing Address - Phone:214-924-3831
Mailing Address - Fax:
Practice Address - Street 1:6101 LONG PRAIRIE RD STE 752
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-6207
Practice Address - Country:US
Practice Address - Phone:214-276-1533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty