Provider Demographics
NPI:1679399166
Name:FUEL TO NOURISH, PLLC
Entity type:Organization
Organization Name:FUEL TO NOURISH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAVINSKAITE
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:847-504-6318
Mailing Address - Street 1:904 JENKINS CT
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-0016
Mailing Address - Country:US
Mailing Address - Phone:847-345-0553
Mailing Address - Fax:
Practice Address - Street 1:904 JENKINS CT
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-0016
Practice Address - Country:US
Practice Address - Phone:847-345-0553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-29
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty