Provider Demographics
NPI:1447889209
Name:NUTRITION BRAVED, LLC
Entity type:Organization
Organization Name:NUTRITION BRAVED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MONTE
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LDN
Authorized Official - Phone:630-474-5321
Mailing Address - Street 1:24W500 MAPLE AVE STE 214
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6057
Mailing Address - Country:US
Mailing Address - Phone:630-474-5321
Mailing Address - Fax:630-487-5267
Practice Address - Street 1:24W500 MAPLE AVE STE 214
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6057
Practice Address - Country:US
Practice Address - Phone:630-474-5321
Practice Address - Fax:630-487-5267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-03
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty