Provider Demographics
NPI:1881134351
Name:NUNNERY, DANIELLE (PH D, RDN, LDN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:NUNNERY
Suffix:
Gender:F
Credentials:PH D, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 SUMMIT AVE APT F
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-3001
Mailing Address - Country:US
Mailing Address - Phone:336-613-6994
Mailing Address - Fax:
Practice Address - Street 1:302 POMONA DR
Practice Address - Street 2:SUITE L
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1663
Practice Address - Country:US
Practice Address - Phone:336-541-6475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL005115133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered