Provider Demographics
NPI:1538603956
Name:NUNLEY, ELAYNA ANN (MS, RDN, LD)
Entity type:Individual
Prefix:MRS
First Name:ELAYNA
Middle Name:ANN
Last Name:NUNLEY
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3555 STAGG DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4509
Mailing Address - Country:US
Mailing Address - Phone:409-212-5980
Mailing Address - Fax:409-212-5957
Practice Address - Street 1:3555 STAGG DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4509
Practice Address - Country:US
Practice Address - Phone:409-212-5980
Practice Address - Fax:409-212-5957
Is Sole Proprietor?:No
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82519133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered