Provider Demographics
NPI:1972852853
Name:DEW, NANCY C (MS, RD, LD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:C
Last Name:DEW
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-5260
Mailing Address - Country:US
Mailing Address - Phone:563-264-2420
Mailing Address - Fax:563-264-5811
Practice Address - Street 1:2400 2ND AVE
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-5260
Practice Address - Country:US
Practice Address - Phone:563-264-2420
Practice Address - Fax:563-264-5811
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01051133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered