Provider Demographics
NPI:1902595952
Name:D1 NUTRITION AND HEALTH, LLC
Entity Type:Organization
Organization Name:D1 NUTRITION AND HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:HANIFA
Authorized Official - Middle Name:HAMEED
Authorized Official - Last Name:DIWAN
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:469-328-0478
Mailing Address - Street 1:408 PARKSIDE CT
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4316
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:408 PARKSIDE CT
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4316
Practice Address - Country:US
Practice Address - Phone:469-328-0478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty