Provider Demographics
NPI:1437178613
Name:NANCY WEBER INC
Entity Type:Organization
Organization Name:NANCY WEBER INC
Other - Org Name:MNT CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:LD
Authorized Official - Phone:843-957-4457
Mailing Address - Street 1:1880 AUBURN LN
Mailing Address - Street 2:24 H
Mailing Address - City:SURFSIDE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29575-5196
Mailing Address - Country:US
Mailing Address - Phone:843-839-9088
Mailing Address - Fax:888-909-5897
Practice Address - Street 1:11945 GRANDHAVEN DR
Practice Address - Street 2:STE G
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-8091
Practice Address - Country:US
Practice Address - Phone:843-839-9088
Practice Address - Fax:888-909-5897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6793OtherMEDICARE GROUP NUMBER