Provider Demographics
NPI:1619968484
Name:GOUVEIA, NANCY KAY (RD)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:KAY
Last Name:GOUVEIA
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 1:410 CHAPELGATE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-4485
Mailing Address - Country:US
Mailing Address - Phone:937-878-1692
Mailing Address - Fax:
Practice Address - Street 1:4881 SUGAR MAPLE DR
Practice Address - Street 2:88 MDG/SGPZ
Practice Address - City:WRIGHT PAT
Practice Address - State:OH
Practice Address - Zip Code:45433-5546
Practice Address - Country:US
Practice Address - Phone:937-904-9361
Practice Address - Fax:937-904-9396
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered