Provider Demographics
NPI:1922839117
Name:NUTRITION WORKS LLC
Entity type:Organization
Organization Name:NUTRITION WORKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RENNER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN, LD
Authorized Official - Phone:307-349-1297
Mailing Address - Street 1:173 INDIAN LOOKOUT DR
Mailing Address - Street 2:
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-3057
Mailing Address - Country:US
Mailing Address - Phone:307-349-1297
Mailing Address - Fax:307-349-1297
Practice Address - Street 1:175 S 5TH ST
Practice Address - Street 2:
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520-3001
Practice Address - Country:US
Practice Address - Phone:307-349-1297
Practice Address - Fax:866-300-0309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-09
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty