Organization
BE NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BASHEERAH ENAHORA RDN, LDN (REGISTERED DIETITIAN AND CEO)
(704) 380-9924
Entity
Organization
Contact information
Practice address
4651 CHARLOTTE PARK DR STE 101C, CHARLOTTE, NC 28217-1916
(704) 380-9924
Mailing address
4651 CHARLOTTE PARK DR STE 101C, CHARLOTTE, NC 28217-1916
(704) 380-9924
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19NJW
BLUE CROSS BLUE SHIELD OF NORTH CAROLINA
NC
Enumeration date
09/23/2019
Last updated
09/23/2019
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