Individual
MRS. ELAINE PATRICIA NISONGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LD
Contact information
Practice address
9713 CHISIK CIR, EAGLE RIVER, AK 99577-8785
(907) 694-4274
(907) 694-4274
Mailing address
9713 CHISIK CIR, EAGLE RIVER, AK 99577-8785
(907) 694-4274
(907) 694-4274
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
140
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140
DIETITIAN LICENSE
AK
01
—
210317
DMA CERTIFICATION NUMBER
AK
01
—
918893
RD ID NUMBER
AK
Enumeration date
11/29/2006
Last updated
06/14/2019
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