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General NPI Number Information
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NPI Number | 1184630444
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Entity Type | Individual
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Provider Name | NANCY LEICHT RD,CDE
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Gender | Female
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 3880 S JONES BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89103-2456
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Country | US
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Telephone | 702-636-3000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 244 #5 CASTALIA
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City | BLUE DIAMOND
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State | NV
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Zip | 89004-0244
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Country | US
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Telephone | 702-875-1992
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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