Provider Demographics
NPI:1851891634
Name:AINSWORTH, NORA (MS, RDN, CDN)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:AINSWORTH
Suffix:
Gender:F
Credentials:MS, RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 OAKLAND RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-3233
Mailing Address - Country:US
Mailing Address - Phone:860-406-3372
Mailing Address - Fax:
Practice Address - Street 1:158 OAKLAND RD
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-3233
Practice Address - Country:US
Practice Address - Phone:860-406-3372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001554133V00000X
CT001559133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty