Provider Demographics
NPI:1407985096
Name:RISSLER, NANCY JOAN (RD,LD)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:JOAN
Last Name:RISSLER
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 1:5808 LAFAYETTE DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-8356
Mailing Address - Country:US
Mailing Address - Phone:972-981-8444
Mailing Address - Fax:972-981-8444
Practice Address - Street 1:6200 W PARK BLVD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6204
Practice Address - Country:US
Practice Address - Phone:972-981-8444
Practice Address - Fax:972-981-8173
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT05926133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered