Provider Demographics
NPI:1790676864
Name:KASEY STROUSE NUTRITION
Entity type:Organization
Organization Name:KASEY STROUSE NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:KASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:STROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LDN, CEDS-C
Authorized Official - Phone:570-640-6778
Mailing Address - Street 1:2082 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5306
Mailing Address - Country:US
Mailing Address - Phone:570-640-6778
Mailing Address - Fax:
Practice Address - Street 1:2082 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5306
Practice Address - Country:US
Practice Address - Phone:570-640-6778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty