Healthcare Provider Details

I. General information

NPI: 1770773483
Provider Name (Legal Business Name): NANCY M. TARR ANDERSON RN,RD,LD,CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS NANCY MARGARET TARR

II. Dates (important events)

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

III. Provider practice location address

901 KENTON STATION DR
MAYSVILLE KY
41056-9609
US

IV. Provider business mailing address

6823 GLEN ARBOR DR
FLORENCE KY
41042-7009
US

V. Phone/Fax

Practice location:
  • Phone: 606-759-0556
  • Fax:
Mailing address:
  • Phone: 859-371-6639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License NumberKY-0884
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: