Doctor Name: | ELIZABETH E. PROSSER |
NPI Number: | 1205856879 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DC |
License Number: | CH8942 |
Business Practice Address: | 320 Tamiami Trl S Nokomis, FL - 342753161 |
Business Phone Number: | 9414840008 |
Business Fax Number: | 9414845899 |
Mailing Address: | 320 Tamiami Trl S, NOKOMIS |
State: | FL |
Postal Code: | 342753161 |
Phone Number: | 9414840008 |
Fax Number: | 9414845899 |
NPI Enumeration Date: | 07/19/2006 |
NPI Last Update Date: | 09/23/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133NN1002X |
License Number: | CH8942 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Nutritionist |
Taxonomy Specialization: | Nutrition, Education |
Taxonomy Definition: |