Provider Demographics
NPI:1316955719
Name:NUTRITION PAIR, LLC
Entity type:Organization
Organization Name:NUTRITION PAIR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LAMBERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:252-335-9355
Mailing Address - Street 1:1908 N ROAD ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-9343
Mailing Address - Country:US
Mailing Address - Phone:252-335-9355
Mailing Address - Fax:844-965-9381
Practice Address - Street 1:1001 LESSIE LN
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-4583
Practice Address - Country:US
Practice Address - Phone:252-335-9355
Practice Address - Fax:252-338-4190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL001745133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty