Provider Demographics
NPI:1013644194
Name:DAVISON, NANCY ANN (MS, RDN, LD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:DAVISON
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:COUP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, RD/LD
Mailing Address - Street 1:400 CHISHOLM PL STE 100
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-6911
Mailing Address - Country:US
Mailing Address - Phone:972-422-9180
Mailing Address - Fax:
Practice Address - Street 1:400 CHISHOLM PL STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6911
Practice Address - Country:US
Practice Address - Phone:972-422-9180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-08
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT05438133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered