Provider Demographics
NPI:1144505199
Name:FAUCHER, ISABELLE (RD LD CSR CDE)
Entity type:Individual
Prefix:
First Name:ISABELLE
Middle Name:
Last Name:FAUCHER
Suffix:
Gender:F
Credentials:RD LD CSR CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4522 EXECUTIVE DR UNIT 103
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119
Mailing Address - Country:US
Mailing Address - Phone:954-464-5839
Mailing Address - Fax:
Practice Address - Street 1:4522 EXECUTIVE DR UNIT 103
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119
Practice Address - Country:US
Practice Address - Phone:954-464-5839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND2784133V00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered