Provider Demographics
NPI:1932933538
Name:CHRISTA LE NUTRITION LLC
Entity type:Organization
Organization Name:CHRISTA LE NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:RD, CSR, LD
Authorized Official - Phone:706-627-6292
Mailing Address - Street 1:10533 HAZELNUT DR
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43064-2565
Mailing Address - Country:US
Mailing Address - Phone:706-627-6292
Mailing Address - Fax:
Practice Address - Street 1:10533 HAZELNUT DR
Practice Address - Street 2:
Practice Address - City:PLAIN CITY
Practice Address - State:OH
Practice Address - Zip Code:43064-2565
Practice Address - Country:US
Practice Address - Phone:706-627-6292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Single Specialty