Provider Demographics
NPI:1699499459
Name:SIMPLY YOU NUTRITION LLC
Entity type:Organization
Organization Name:SIMPLY YOU NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:VANLUVANEE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, CSSD, LDN
Authorized Official - Phone:910-515-8475
Mailing Address - Street 1:1178 YELLOWWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315-6701
Mailing Address - Country:US
Mailing Address - Phone:910-250-8915
Mailing Address - Fax:
Practice Address - Street 1:1642 MILITARY CUTOFF RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5716
Practice Address - Country:US
Practice Address - Phone:910-250-8915
Practice Address - Fax:866-854-3116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty