Organization
MEDICAL NUTRITION SERVICES, LLC
Active
Organization
MEDICAL NUTRITION SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTA M SIMONETTI MS, CNS (OWNER)
(480) 204-6006
Entity
Organization
Contact information
Practice address
1198 W KELLY LN, TEMPE, AZ 85284-3772
(480) 204-6006
(480) 436-6006
Mailing address
1198 W KELLY LN, TEMPE, AZ 85284-3772
(480) 204-6006
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
133VN1005X
Renal Nutrition Registered Dietitian
—
—
133VN1006X
Metabolic Nutrition Registered Dietitian
—
—
Other
Enumeration date
04/08/2013
Last updated
06/29/2013
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