Provider Demographics
NPI:1427844067
Name:NOURISH 4 WELLNESS
Entity type:Organization
Organization Name:NOURISH 4 WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:785-393-9173
Mailing Address - Street 1:PO BOX 50415
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79710-0415
Mailing Address - Country:US
Mailing Address - Phone:432-314-2818
Mailing Address - Fax:
Practice Address - Street 1:2205 CIMMARON DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-7461
Practice Address - Country:US
Practice Address - Phone:432-314-2818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty