Provider Demographics
NPI:1538830369
Name:HEALTHY LIVING NUTRITION
Entity type:Organization
Organization Name:HEALTHY LIVING NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LYNZI
Authorized Official - Middle Name:N
Authorized Official - Last Name:GLASSCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, RDN, LDN
Authorized Official - Phone:337-466-6899
Mailing Address - Street 1:3320 HIGHWAY 190
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-5126
Mailing Address - Country:US
Mailing Address - Phone:337-466-6899
Mailing Address - Fax:337-270-6305
Practice Address - Street 1:3320 HIGHWAY 190
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-5126
Practice Address - Country:US
Practice Address - Phone:337-466-6899
Practice Address - Fax:337-270-6305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center