Healthcare Provider Details

I. General information

NPI: 1780811414
Provider Name (Legal Business Name): NANCY E VARSANO CDE, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY ELLEN DELUCA CDE, RD

II. Dates (important events)

Enumeration Date: 06/21/2009
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 E CAMBRIDGE AVE STE 301
PHOENIX AZ
85006-1464
US

IV. Provider business mailing address

2108 E THOMAS RD STE 130
PHOENIX AZ
85016-7761
US

V. Phone/Fax

Practice location:
  • Phone: 602-933-0935
  • Fax: 602-933-2471
Mailing address:
  • Phone: 602-933-1815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number721220
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: