Provider Demographics
NPI:1326215500
Name:TUFT, PRISCILLA VICTORIA (LSN, CPT)
Entity type:Individual
Prefix:MRS
First Name:PRISCILLA
Middle Name:VICTORIA
Last Name:TUFT
Suffix:
Gender:F
Credentials:LSN, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12015 WHITMARSH LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-1737
Mailing Address - Country:US
Mailing Address - Phone:813-597-0202
Mailing Address - Fax:813-855-8362
Practice Address - Street 1:12015 WHITMARSH LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-1737
Practice Address - Country:US
Practice Address - Phone:813-597-0202
Practice Address - Fax:813-855-8362
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA041014001133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education