Provider Demographics
NPI:1659542819
Name:NANCE, JULIE C (RD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:C
Last Name:NANCE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4000 COLISEUM DR
Mailing Address - Street 2:STE 420
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-5906
Mailing Address - Country:US
Mailing Address - Phone:757-827-2313
Mailing Address - Fax:757-827-2173
Practice Address - Street 1:4000 COLISEUM DR
Practice Address - Street 2:STE 420
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-5906
Practice Address - Country:US
Practice Address - Phone:757-827-2313
Practice Address - Fax:757-827-2173
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002790133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered