Provider Demographics
NPI:1821771510
Name:NELTNER, ELLEN (RD)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:NELTNER
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 1:3219 CLIFTON AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220-3045
Mailing Address - Country:US
Mailing Address - Phone:513-862-4957
Mailing Address - Fax:513-862-4952
Practice Address - Street 1:3219 CLIFTON AVE STE 300
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-3045
Practice Address - Country:US
Practice Address - Phone:513-862-4957
Practice Address - Fax:513-862-4952
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.10211133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered