Provider Demographics
NPI:1730534892
Name:NAGY, ELLERIE (ND)
Entity type:Individual
Prefix:DR
First Name:ELLERIE
Middle Name:
Last Name:NAGY
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 OSOS ST STE E
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-3213
Mailing Address - Country:US
Mailing Address - Phone:805-316-1364
Mailing Address - Fax:805-316-0363
Practice Address - Street 1:890 OSOS ST STE E
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3213
Practice Address - Country:US
Practice Address - Phone:805-316-1364
Practice Address - Fax:503-316-1364
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3711171100000X
CA1150175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist