Basic Information
| Provider Information | |||||||||
| NPI: | 1518082718 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NAGEL | ||||||||
| FirstName: | DARCIE | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | RD, CSR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11161 MAGNOLIA AVE | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925053605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095575248 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11161 MAGNOLIA AVE | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925053605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9513518090 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2007 | ||||||||
| LastUpdateDate: | 04/18/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.