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NPI Code Detail

MEDICARE: MRS. NORMA NASR RD

MEDICARE: MRS. NORMA NASR RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian37000224AIN

General Provider Information

NPI Number : 1407064512
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NORMA NASR RD
Provider Business Mailing Address
First Line : 445 MAPLEWOOD TRL
Second Line :
City : MICHIGAN CITY
State : IN
Zip : 46360-1843
Country : US
Telephone Number : 219-874-4822
Fax Number :
Provider Business Practice Location Address
First Line : 445 MAPLEWOOD TRL
Second Line :
City : MICHIGAN CITY
State : IN
Zip : 46360-1843
Country : US
Telephone Number : 219-874-4822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 07/08/2007

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