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General NPI Number Information
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NPI Number | 1194935346
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Entity Type | Individual
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Provider Name | NANCY MORRELL RD
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 WASHINGTON SQ
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City | NEW BRITAIN
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State | CT
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Zip | 06051-1848
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Country | US
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Telephone | 860-224-3642
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Fax | 860-638-6601
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Provider Business Mailing Address
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Address Line | 635 MAIN ST ATTN CREDENTIALING DEPARTMENT
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City | MIDDLETOWN
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State | CT
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Zip | 06457-2718
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Country | US
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Telephone | 860-347-6971
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Fax | 860-638-6601
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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 | 000632
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License Number State | CT
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