Provider Demographics
NPI:1811173875
Name:FARLEY-ZOUCHA, NORMA ELAINE (RD, LMNT, LD)
Entity type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:ELAINE
Last Name:FARLEY-ZOUCHA
Suffix:
Gender:F
Credentials:RD, LMNT, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 ROAD 7
Mailing Address - Street 2:
Mailing Address - City:SCHUYLER
Mailing Address - State:NE
Mailing Address - Zip Code:68661-7111
Mailing Address - Country:US
Mailing Address - Phone:402-615-0864
Mailing Address - Fax:402-352-5800
Practice Address - Street 1:236 ROAD 7
Practice Address - Street 2:
Practice Address - City:SCHUYLER
Practice Address - State:NE
Practice Address - Zip Code:68661-7111
Practice Address - Country:US
Practice Address - Phone:402-615-0864
Practice Address - Fax:402-352-5800
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE688133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered