Individual
MS. PAMELA M. NISEVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, CSSD, LD
Contact information
Practice address
1 CHILDRENS PLZ, DAYTON, OH 45404-1898
(937) 641-3434
Mailing address
2588 LANTZ RD, BEAVERCREEK, OH 45434-6806
(937) 641-3434
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD.5879
OH
133VN1004X
Pediatric Nutrition Registered Dietitian
LD.5879
OH
Other
Enumeration date
06/19/2007
Last updated
09/25/2009
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