Provider Demographics
NPI:1619109394
Name:FARRELL, NANCY Z (RD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:Z
Last Name:FARRELL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 PARK HILL DR STE A
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3361
Mailing Address - Country:US
Mailing Address - Phone:540-479-3404
Mailing Address - Fax:
Practice Address - Street 1:231 PARK HILL DR STE A
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3361
Practice Address - Country:US
Practice Address - Phone:540-479-3404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-14
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered