Provider Demographics
NPI:1366322273
Name:KB NUTRITION CONSULTING LLC
Entity type:Organization
Organization Name:KB NUTRITION CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSHER
Authorized Official - Suffix:
Authorized Official - Credentials:RD/LD
Authorized Official - Phone:918-261-2361
Mailing Address - Street 1:5303 GREENAN DR
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-3328
Mailing Address - Country:US
Mailing Address - Phone:918-261-2361
Mailing Address - Fax:
Practice Address - Street 1:5303 GREENAN DR
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-3328
Practice Address - Country:US
Practice Address - Phone:918-261-2361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty