Lifestyle Nutrition and Wellness, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

LIFESTYLE NUTRITION AND WELLNESS, LLC

Practice address

9800 Moody CT
Harrisburg, NC 28075-6643

Phone

(248) 909-8555

NPI assigned

Sep 21, 2021

Organization subpart

No

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

Authorized official

Name

Jennifer Bourbonnais, MED, RD, LDNNPI 1710005608

Title

Registered Dietitian

Phone

(248) 909-8555

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.

• Jennifer Bourbonnais, MED, RD, LDN

  • Registered Dietitian
  • Harrisburg, NC
  • NPI 1710005608

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632268800000",
    "number": "1629749544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 MOODY CT",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280756643",
            "telephone_number": "248-909-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 MOODY CT",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280756643",
            "telephone_number": "248-909-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE NUTRITION AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-21",
        "status": "A",
        "authorized_official_last_name": "BOURBONNAIS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "248-909-8555",
        "authorized_official_credential": "MED, RD, LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Niki Alexandria Kushell
• Tin Duy Lam, D.D.S.
• April Arthur Lamanno, PHD
• Carol Lebaron, SLP
• Lend a Hand Home Care LLC
• Lila Community Enhance Services Inc.
• Bradley William Lind, D.P.M.
• Pamela A. Linker, D.D.S.
• Tammy Lynn Little
• Mark Anthony Lockett

• Registered Dietitian in Harrisburg, NC
• Providers in Harrisburg, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.