Provider Demographics
NPI:1225533953
Name:DASENBROCK, NONA LYNEL (RDN)
Entity type:Individual
Prefix:
First Name:NONA
Middle Name:LYNEL
Last Name:DASENBROCK
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:NONA
Other - Middle Name:LYNEL
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:10912 E BUTHERUS DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-1850
Mailing Address - Country:US
Mailing Address - Phone:480-688-1140
Mailing Address - Fax:
Practice Address - Street 1:10912 E BUTHERUS DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255
Practice Address - Country:US
Practice Address - Phone:480-688-1140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered