Provider Demographics
NPI:1154150753
Name:BLUEGRASS NUTRITION SOLUTIONS
Entity type:Organization
Organization Name:BLUEGRASS NUTRITION SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:606-434-6436
Mailing Address - Street 1:3394 KY ROUTE 3385
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-8001
Mailing Address - Country:US
Mailing Address - Phone:606-434-6436
Mailing Address - Fax:
Practice Address - Street 1:3394 KY ROUTE 3385
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-8001
Practice Address - Country:US
Practice Address - Phone:606-434-6436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty