Healthcare Provider Details

I. General information

NPI: 1023173630
Provider Name (Legal Business Name): BARBARA ANN NAKANISHI RD,LD,CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 04/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 HOSPITAL DRIVE, CORNWELL CENTER ARHI DIABETES CENTER
ATHENS OH
45701
US

IV. Provider business mailing address

65 HOSPITAL DRIVE, CORNWELL CENTER ARHI DIABETES CENTER
ATHENS OH
45701
US

V. Phone/Fax

Practice location:
  • Phone: 740-566-4870
  • Fax: 740-566-4871
Mailing address:
  • Phone: 740-566-4870
  • Fax: 740-566-4871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD.2877
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: