Provider Demographics
NPI:1124354022
Name:NEWKIRK, NANCY HELEN (RD)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:HELEN
Last Name:NEWKIRK
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3811 W DE LEON ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4412
Mailing Address - Country:US
Mailing Address - Phone:813-420-5575
Mailing Address - Fax:813-396-9746
Practice Address - Street 1:3811 W DE LEON ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4412
Practice Address - Country:US
Practice Address - Phone:813-420-5575
Practice Address - Fax:813-396-9746
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric