Provider Demographics
NPI:1831514249
Name:RAMIREZ, NANCY M (LCDA)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:LCDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:L8 CALLE 6
Mailing Address - Street 2:URB. VILLA REAL
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-4528
Mailing Address - Country:US
Mailing Address - Phone:787-983-1954
Mailing Address - Fax:
Practice Address - Street 1:L8 CALLE 6
Practice Address - Street 2:URB. VILLA REAL
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-4528
Practice Address - Country:US
Practice Address - Phone:787-983-1954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR133N00000X133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist