| Doctor Name: | MS. NANCY M. WISE |
| NPI Number: | 1730497975 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S.,R.D.,L.D/N |
| License Number: | ND 5781 |
| Business Practice Address: | 35 Cambridge Trce Ormond Beach, FL - 321742471 |
| Business Phone Number: | 3862951265 |
| Business Fax Number: | 8887857846 |
| Mailing Address: | 35 Cambridge Trce, ORMOND BEACH |
| State: | FL |
| Postal Code: | 321742471 |
| Phone Number: | 3866750790 |
| Fax Number: | 8887857846 |
| NPI Enumeration Date: | 09/22/2010 |
| NPI Last Update Date: | 10/31/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | ND 5781 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |