Provider Demographics
NPI:1700913936
Name:ALEXANDER-WADEL, NANCY (RD, CDE)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:ALEXANDER-WADEL
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:MISS
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:8930 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-5117
Mailing Address - Country:US
Mailing Address - Phone:619-466-3317
Mailing Address - Fax:619-466-3317
Practice Address - Street 1:751 MEDICAL CENTER CT
Practice Address - Street 2:SHARP CHULA VISTA MEDICAL CENTER
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6617
Practice Address - Country:US
Practice Address - Phone:619-482-5938
Practice Address - Fax:619-482-5861
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
665612133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered