Provider Demographics
NPI:1053905380
Name:ORSA NUTRITION
Entity type:Organization
Organization Name:ORSA NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN- OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:ORSA
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:703-915-6989
Mailing Address - Street 1:12828 GREAT OAK LN
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:VA
Mailing Address - Zip Code:20124-1521
Mailing Address - Country:US
Mailing Address - Phone:703-915-6989
Mailing Address - Fax:855-754-1135
Practice Address - Street 1:12828 GREAT OAK LN
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:VA
Practice Address - Zip Code:20124-1521
Practice Address - Country:US
Practice Address - Phone:703-915-6989
Practice Address - Fax:855-754-1135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty