NPI 1053883520

Great Basin Nutrition LLC

Organisation Registered Dietitian Carson City, NV

Practice location

Address: 783 Basque Way STE 103, Carson City, NV 89706-7981
Phone: (775) 720-3490
Fax: (775) 245-2867

Authorised official

Name: Jodi Pettersen
Title: Owner
Phone: (775) 720-3490

Registered specialties

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X

Other Dietitian, Registered providers in Nevada →

Registry record

NPI: 1053883520
Entity type: Organization
NPI issued: 21 Dec 2018
Record last updated: 21 Dec 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.