Organization
HEALTHY GREEN NUTRITION, LLC
Active
Other names
Healthy Green Nutrition, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
VALARIE DIANE GREENLEAF-KISNER MS, RDN, LD, CDCES (OWNER)
(316) 253-2604
Entity
Organization
Contact information
Practice address
9415 E HARRY ST STE 407, WICHITA, KS 67207-5083
(316) 253-2604
(316) 634-3789
Mailing address
12210 E BOXTHORN ST, WICHITA, KS 67226-8263
(316) 253-2604
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
20220205
KS
133V00000X
Registered Dietitian
Primary
717684
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100210590A
—
KS
Enumeration date
08/22/2015
Last updated
09/20/2021
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