Provider Demographics
NPI:1023682200
Name:PALMETTO NUTRITION CONSULTING, LLC
Entity type:Organization
Organization Name:PALMETTO NUTRITION CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-271-0806
Mailing Address - Street 1:69 ROBERT SMALLS PKWY STE 3D
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29906-4275
Mailing Address - Country:US
Mailing Address - Phone:843-271-0806
Mailing Address - Fax:843-582-0271
Practice Address - Street 1:69 ROBERT SMALLS PKWY STE 3D
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29906-4275
Practice Address - Country:US
Practice Address - Phone:843-271-0806
Practice Address - Fax:843-582-0271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-13
Last Update Date:2022-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty