Provider Demographics
NPI:1992491294
Name:NUTRITION FROM SCRATCH
Entity type:Organization
Organization Name:NUTRITION FROM SCRATCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:KOENIGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-909-7609
Mailing Address - Street 1:2450 SUNRISE RIDGE WAY APT 302
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37921-1262
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2450 SUNRISE RIDGE WAY APT 302
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921-1262
Practice Address - Country:US
Practice Address - Phone:865-909-7609
Practice Address - Fax:865-240-3169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1194434456OtherNPPES