Healthcare Provider Details

I. General information

NPI: 1386102028
Provider Name (Legal Business Name): NANCY RUFF ROZGONY MS, RDN, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2019
Last Update Date: 03/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8118 ELIZABETH RD
PASADENA MD
21122-2209
US

IV. Provider business mailing address

8118 ELIZABETH RD
PASADENA MD
21122-2209
US

V. Phone/Fax

Practice location:
  • Phone: 443-794-2472
  • Fax:
Mailing address:
  • Phone: 443-794-2472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License NumberDX2558
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDX2558
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberDX2558
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: