Provider Demographics
NPI:1962257469
Name:NUNEZ, GRACIELA (RD, LD)
Entity type:Individual
Prefix:
First Name:GRACIELA
Middle Name:
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5169 WILLOW CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932-2521
Mailing Address - Country:US
Mailing Address - Phone:915-929-3899
Mailing Address - Fax:
Practice Address - Street 1:5169 WILLOW CREEK CIR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79932-2521
Practice Address - Country:US
Practice Address - Phone:915-929-3899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered