Provider Demographics
NPI:1174819940
Name:SCHEPKA, NANCY LEE (RD, LD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LEE
Last Name:SCHEPKA
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 BOARDMAN CANFIELD RD
Mailing Address - Street 2:SUITE #102
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4236
Mailing Address - Country:US
Mailing Address - Phone:330-729-1320
Mailing Address - Fax:330-729-1320
Practice Address - Street 1:833 BOARDMAN CANFIELD RD
Practice Address - Street 2:SUITE #102
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4236
Practice Address - Country:US
Practice Address - Phone:330-729-1320
Practice Address - Fax:330-729-1320
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4636133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered