Provider Demographics
NPI:1215973748
Name:HERRIN, MARCIA (EDD, MPH, RD, LD)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:
Last Name:HERRIN
Suffix:
Gender:F
Credentials:EDD, MPH, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 154
Mailing Address - Street 2:
Mailing Address - City:ENFIELD CENTER
Mailing Address - State:NH
Mailing Address - Zip Code:03749-0154
Mailing Address - Country:US
Mailing Address - Phone:603-632-4084
Mailing Address - Fax:603-646-3633
Practice Address - Street 1:367 ROUTE 120
Practice Address - Street 2:SUITE B-8
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1430
Practice Address - Country:US
Practice Address - Phone:603-643-7677
Practice Address - Fax:603-643-3633
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH71133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered