GRAND TRAVERSE NUTRITION LLC NPI 1396160388

NPI Information

NPI: 1396160388
Provider Name: GRAND TRAVERSE NUTRITION, LLC
Classification: Dietitian, Registered - 133V00000X
Entity Type: Organization
Address: 800 COTTAGEVIEW DR
SUITE 1076
TRAVERSE CITY, MI
ZIP 49684
Phone: (231) 632-1522

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NPI Details

GRAND TRAVERSE NUTRITION, LLC is a dietitian registered in Traverse City, MI. The provider is a Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation. GRAND TRAVERSE NUTRITION, LLC NPI is 1396160388. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

800 COTTAGEVIEW DR
SUITE 1076
TRAVERSE CITY, MI
ZIP 49684-616
Phone: (231) 632-1522

The provider's authorized official is Miranda Monroe .
The authorized official title is Member/owner and has the following contact phone number (231) 632-1522.

The enumeration date for this NPI number is 2/27/2014 and was last updated on 2/27/2014.

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
1	133V00000X	Dietitian, Registered				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	851200	OTHER	MICHIGAN	RDN - COMMISSION DIETETIC REGISTRATION

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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