Provider Demographics
NPI:1336381490
Name:NOONCHESTER, DARCI (MS, RD)
Entity type:Individual
Prefix:MRS
First Name:DARCI
Middle Name:
Last Name:NOONCHESTER
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59150 MONTEGO DR
Mailing Address - Street 2:
Mailing Address - City:NEW HUDSON
Mailing Address - State:MI
Mailing Address - Zip Code:48165-8541
Mailing Address - Country:US
Mailing Address - Phone:248-736-2161
Mailing Address - Fax:
Practice Address - Street 1:10315 GRAND RIVER RD
Practice Address - Street 2:SUITE 308
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-9594
Practice Address - Country:US
Practice Address - Phone:248-736-2161
Practice Address - Fax:810-272-4377
Is Sole Proprietor?:No
Enumeration Date:2009-04-03
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI890483133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI20-8083282Medicare UPIN