Provider Demographics
NPI:1679672174
Name:LITCH, NANCY (RD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:LITCH
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 1:9012 SILVER PINE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH LYON
Mailing Address - State:MI
Mailing Address - Zip Code:48178-9367
Mailing Address - Country:US
Mailing Address - Phone:734-761-7968
Mailing Address - Fax:
Practice Address - Street 1:9012 SILVER PINE DRIVE
Practice Address - Street 2:
Practice Address - City:SOUTH LYON
Practice Address - State:MI
Practice Address - Zip Code:48178-9367
Practice Address - Country:US
Practice Address - Phone:734-761-7968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered