Provider Demographics
NPI:1497642961
Name:GUGERTY, NANCY LEE (RD, RN)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:LEE
Last Name:GUGERTY
Suffix:
Gender:F
Credentials:RD, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 BRIDLESHIRE RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-2450
Mailing Address - Country:US
Mailing Address - Phone:302-463-9416
Mailing Address - Fax:
Practice Address - Street 1:33 BRIDLESHIRE RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-2450
Practice Address - Country:US
Practice Address - Phone:302-463-9416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0032196163W00000X
PARN782840163W00000X
DEDN-0010817133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No163W00000XNursing Service ProvidersRegistered Nurse