Provider Demographics
NPI:1336388487
Name:BAME, NANETTE B (RD)
Entity type:Individual
Prefix:
First Name:NANETTE
Middle Name:B
Last Name:BAME
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 1:6220 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-2565
Mailing Address - Country:US
Mailing Address - Phone:702-606-7546
Mailing Address - Fax:
Practice Address - Street 1:3460 W CHEYENNE AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-8241
Practice Address - Country:US
Practice Address - Phone:702-883-2838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-12
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV426998133V00000X
NV32479-DI-5133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered