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Individual

CAROLINE GRACE NUSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MCN, RD, LD

Contact information

Practice address
2001 INWOOD RD, DALLAS, TX 75390-7202
(214) 728-6033
Mailing address
PO BOX 845347, DALLAS, TX 75284-7208

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DT85655
TEXAS DEPARTMENT OF LICENSING AND REGULATION
TX
Enumeration date
11/15/2018
Last updated
12/10/2018
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