Provider Demographics
NPI:1447061445
Name:NUTRIDS, LLC
Entity type:Organization
Organization Name:NUTRIDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRINCIPAL DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMILEY
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LDN, CD-N
Authorized Official - Phone:803-707-4974
Mailing Address - Street 1:7730 HEATHERSIDE LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-6979
Mailing Address - Country:US
Mailing Address - Phone:803-707-4974
Mailing Address - Fax:
Practice Address - Street 1:7730 HEATHERSIDE LN APT 683
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-6979
Practice Address - Country:US
Practice Address - Phone:803-707-4974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty