Provider Demographics
NPI:1952431611
Name:PARKINSON, NANCY SHARON (MS RD CD LD)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:SHARON
Last Name:PARKINSON
Suffix:
Gender:F
Credentials:MS RD CD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 N LAKESIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5264
Mailing Address - Country:US
Mailing Address - Phone:765-254-1580
Mailing Address - Fax:
Practice Address - Street 1:4904 NORTH WHEELING AVENUE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-5264
Practice Address - Country:US
Practice Address - Phone:765-282-6197
Practice Address - Fax:765-282-1901
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37001648A133V00000X
OHLD5863133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered