Provider Demographics
NPI:1861192965
Name:LE-NUTRITION LLC
Entity type:Organization
Organization Name:LE-NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:MCCARTHY
Authorized Official - Last Name:KERN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LD, IFNCP
Authorized Official - Phone:682-235-9884
Mailing Address - Street 1:6313 LAKE WORTH BLVD # 1029
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76135-3601
Mailing Address - Country:US
Mailing Address - Phone:682-235-9884
Mailing Address - Fax:
Practice Address - Street 1:1751 RIVER RUN STE 200
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-6670
Practice Address - Country:US
Practice Address - Phone:682-235-9884
Practice Address - Fax:682-316-9294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-07
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty