Provider Demographics
NPI:1164300802
Name:FREE TELEHEALTH NUTRITION
Entity type:Organization
Organization Name:FREE TELEHEALTH NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIE NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:DENEEN
Authorized Official - Last Name:KNOTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-573-4882
Mailing Address - Street 1:15968 W VENTURA ST
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-5158
Mailing Address - Country:US
Mailing Address - Phone:760-573-4882
Mailing Address - Fax:
Practice Address - Street 1:15968 W VENTURA ST
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-5158
Practice Address - Country:US
Practice Address - Phone:760-573-4882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty