Provider Demographics
NPI:1659701019
Name:NARA, DEANNA MARIE (MS, CNS, LDN)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:MARIE
Last Name:NARA
Suffix:
Gender:F
Credentials:MS, CNS, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 WASHINGTON PL NE
Mailing Address - Street 2:APT. 428
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-1053
Mailing Address - Country:US
Mailing Address - Phone:240-315-3778
Mailing Address - Fax:
Practice Address - Street 1:4908 BERWYN RD
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-2111
Practice Address - Country:US
Practice Address - Phone:301-474-8791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX3515133N00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered