Provider Demographics
NPI:1174800577
Name:NUTRITION IN MOTION
Entity type:Organization
Organization Name:NUTRITION IN MOTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:VIEREGGE
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:MS,RD,LDN
Authorized Official - Phone:910-239-3562
Mailing Address - Street 1:2517 DELANEY AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6003
Mailing Address - Country:US
Mailing Address - Phone:910-239-3562
Mailing Address - Fax:877-889-2993
Practice Address - Street 1:2517 DELANEY AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6003
Practice Address - Country:US
Practice Address - Phone:910-239-3562
Practice Address - Fax:877-889-2993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL001969133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty