Provider Demographics
NPI:1427463827
Name:NUSSGRUBER, KIRSTIN (CNC)
Entity type:Individual
Prefix:
First Name:KIRSTIN
Middle Name:
Last Name:NUSSGRUBER
Suffix:
Gender:F
Credentials:CNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 WASHINGTON VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:BEDMINSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07921-2119
Mailing Address - Country:US
Mailing Address - Phone:908-658-4900
Mailing Address - Fax:908-658-4132
Practice Address - Street 1:75 WASHINGTON VALLEY RD
Practice Address - Street 2:
Practice Address - City:BEDMINSTER
Practice Address - State:NJ
Practice Address - Zip Code:07921-2119
Practice Address - Country:US
Practice Address - Phone:908-658-4900
Practice Address - Fax:908-658-4132
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist