WISE NUTRITION LLC NPI 1255638797

NPI Information

  • NPI: 1255638797
  • Provider Name: WISE NUTRITION LLC
  • Classification: Dietitian, Registered - 133VN1005X
  • Specialization: Nutrition, Renal
  • Entity Type: Organization
  • Former Legal Business Name: NANCY M WISE
  • Address: 35 CAMBRIDGE TRCE
    ORMOND BEACH, FL
    ZIP 32174
  • Phone: (386) 675-0790

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NPI Details

WISE NUTRITION LLC is a nutrition and renal dietitian registered in Ormond Beach, FL. The provider is an individual who is a Board Certified Specialist in Renal Nutrition and works directly with adult and/or pediatric patients with acute kidney injury, chronic kidney disease (CKD) stages 1-5, or receiving renal replacement therapies (dialysis/transplant) in a variety of settings, OR works indirectly in management, education, or research practice linked specifically to renal nutrition. The specialist in renal/nephrology nutrition is responsible for nutrition assessment, diagnosis, intervention, monitoring, and evaluation. WISE NUTRITION LLC NPI is 1255638797. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Nancy M Wise.

The provider's business location address is:

35 CAMBRIDGE TRCE
ORMOND BEACH, FL
ZIP 32174-471
Phone: (386) 675-0790
Fax: (888) 785-7846

The provider's authorized official is Nancy M Wise .
The authorized official title is Sole Proprietor and has the following contact phone number (386) 295-1265.

The enumeration date for this NPI number is 2/18/2011 and was last updated on 11/1/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1133VN1005XDietitian, RegisteredNutrition, RenalND5781FLORIDAYes

What is NPI?

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This page was last updated on: 11/21/2025

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