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General NPI Number Information
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NPI Number | 1316223878
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Entity Type | Individual
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Provider Name | NANCY B CARROTHERS LD/RD
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Gender | Female
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Dates
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Enumeration Date | 10/28/2011
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Last Update Date | 10/28/2011
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Provider Practice Location Address
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Address Line | 3435 TROY RD
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City | SPRINGFIELD
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State | OH
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Zip | 45504-4335
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Country | US
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Telephone | 937-342-8800
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Fax | 937-342-8805
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Provider Business Mailing Address
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Address Line | 6653 APACHE CIR
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City | CINCINNATI
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State | OH
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Zip | 45243-2403
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Country | US
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Telephone | 513-833-4551
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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 | 2053
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License Number State | OH
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