Provider Demographics
NPI:1205669439
Name:NOURISHED TRANSITIONS PLLC
Entity type:Organization
Organization Name:NOURISHED TRANSITIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RONDERO
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:559-408-8112
Mailing Address - Street 1:1702 W 35TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60609-1223
Mailing Address - Country:US
Mailing Address - Phone:559-408-8112
Mailing Address - Fax:
Practice Address - Street 1:1702 W 35TH ST APT 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60609-1223
Practice Address - Country:US
Practice Address - Phone:559-408-8112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-22
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty