Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nutrisource Nutritional Services, Inc

Organization Registered Dietitian · NPI 1932486966

Nutrisource Nutritional Services, Inc is a Registered Dietitian in Saint Simons Island, Georgia. Licensed in Georgia. Registered with an NPI since 2011.

Licensed in
GA
In the registry since
2011
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

504 Beachview Dr Ste 2A
Saint Simons Island, GA 31522-4740
Phone: (912) 222-7755
Fax: (912) 434-7018
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence LD002579 (GA)

Record details

NPI number1932486966
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lauren Bailey — Owner · (912) 222-7755
Other names Nutrisource, Inc.
NPI enumeratedNovember 4, 2011
Last updated in NPPESNovember 4, 2011
Mailing address620 Sea Island Rd, Pmb 273, Saint Simons Island, GA 31522-1767

Other providers in Saint Simons Island