Provider Demographics
NPI:1558033670
Name:LA MARCA, NINA KATHERINE (RD, LD)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:KATHERINE
Last Name:LA MARCA
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:KATHERINE
Other - Last Name:LAMARCA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD, LD
Mailing Address - Street 1:4160 PEACH TREE LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-4714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4160 PEACH TREE LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-4714
Practice Address - Country:US
Practice Address - Phone:655-530-9167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2024-09-14
Deactivation Date:2022-01-21
Deactivation Code:
Reactivation Date:2024-05-30
Provider Licenses
StateLicense IDTaxonomies
IN37002885A133VN1301X
AR2041133V00000X
718631133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1301XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Oncology