Vegan Fit for Life LLC

Primary specialty

NutritionistTaxonomy code 133N00000X

Legal business name

VEGAN FIT FOR LIFE LLC

Practice address

4541 Quartz Dr NE
Rio Rancho, NM 87124-4910

Phone

(505) 377-0059

NPI assigned

Oct 17, 2023

Organization subpart

No

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

Authorized official

Name

Clarissa Kay Gannon

Title

Ceo

Phone

(505) 377-0059

Specialties & licenses 1

Addresses

Other names 1

• Elite Fit For Life Former legal business name

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

{
    "created_epoch": "1697500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1659153427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4541 QUARTZ DR NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871244910",
            "telephone_number": "505-377-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4541 QUARTZ DR NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871244910",
            "telephone_number": "505-377-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEGAN FIT FOR LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "GANNON",
        "authorized_official_first_name": "CLARISSA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-377-0059"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Fit For Life",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Stephen Michael Vaughan, DMD
• Stephen Anthony Vaughn, MD
• Alexandria Vazquez
• Jordan Veater
• Vee Cares LLC
• Nanette C Vela, NP
• Angelina Alize Velarde
• Anjelica Velarde
• Kaitlynn Velarde
• Alyssa Joanne Velasco, MD

• Nutritionist in Rio Rancho, NM
• Providers in Rio Rancho, NM by specialty
• Nutritionist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.