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Contact Information

MD NUTRITION AND LIFESTYLE, LLC
5901 KINGSTOWNE VILLAGE PKWY
SUITE 300
KINGSTOWNE, VA22315
 Phone: 860-796-1930
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for MD NUTRITION AND LIFESTYLE LLC · (Female)

NPI Number 1972002301
Status Active
Credentials
Entity Individual
Enumeration date 02/12/2018
Last updated 02/12/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • CT License # 001415
  • NC License # L002913
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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