Individual
MS. NANCY JO STAFFORD-WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CD
Contact information
Practice address
2209 JOHN R WOODEN DR, MARTINSVILLE, IN 46151-1840
(765) 349-6500
(765) 349-6446
Mailing address
2209 JOHN R WOODEN DR, MARTINSVILLE, IN 46151-1840
(765) 349-6500
(765) 349-6446
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37001033A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12715
CDR
IN
01
—
37001033A
DIETITIAN CERTIFICATION
IN
Enumeration date
07/16/2007
Last updated
07/16/2007
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