Healthcare Provider Details

I. General information

NPI: 1841251014
Provider Name (Legal Business Name): NANCY D HUFFSTETLER RD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: NANCY A DAINE

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43830 10TH ST W
LANCASTER CA
93534-4826
US

IV. Provider business mailing address

2820 W AVENUE N L4
LANCASTER CA
93551-2426
US

V. Phone/Fax

Practice location:
  • Phone: 661-940-1452
  • Fax:
Mailing address:
  • Phone: 661-943-4947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: