Prudent-Lifestyles Nutrition Services, Inc.

Primary specialty

Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X

Legal business name

PRUDENT-LIFESTYLES NUTRITION SERVICES, INC.

Practice address

17570 San Rosa Blvd
Lathrup Village, MI 48076-2715

Phone

(248) 866-4967

Fax

(248) 559-5081

NPI assigned

Jul 18, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Tonja Maria Stallings, R.D.NPI 1871616219

Title

Dietitian

Phone

(248) 866-4967

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tonja Maria Stallings, R.D.

  • Metabolic Nutrition Registered Dietitian
  • Lathrup Village, MI
  • NPI 1871616219

  Nutrition, Metabolic

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186358400000",
    "number": "1124228275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17570 SAN ROSA BLVD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480762715",
            "telephone_number": "248-866-4967",
            "fax_number": "248-559-5081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17570 SAN ROSA BLVD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480762715",
            "telephone_number": "248-866-4967",
            "fax_number": "248-559-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUDENT-LIFESTYLES NUTRITION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-08-06",
        "status": "A",
        "authorized_official_last_name": "STALLINGS",
        "authorized_official_first_name": "TONJA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "DIETITIAN",
        "authorized_official_telephone_number": "248-866-4967",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.D."
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Metabolic Nutrition Registered Dietitian in Lathrup Village, MI
• Providers in Lathrup Village, MI by specialty
• Metabolic Nutrition Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.