Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
THERESA RENEE NICKOLAUS, RD, LD, IBCLC
Active Sole ProprietorTHERESA RENEE NICKOLAUS, RD, LD, IBCLC is a Registered Dietitian healthcare provider located in IMPERIAL, Missouri. NPI 1922774751 is currently active in the NPPES registry. Verify at CMS.
Registered Dietitian · IMPERIAL, MO
Registration Details
- NPI Number
- 1922774751
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 20, 2021 (4.9450931531371 yrs)
- Last Updated
- Aug 20, 2021
- Licenses
-
L-1248842011041352 (MO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1011 SCENIC OAKS CTIMPERIAL, MO, 630523457Browse MO providers · Browse ZIP 63052
- Phone
- 3143636186
- Primary Specialty
-
Registered Dietitian
133V00000X
- Additional Specialty
- Registered Dietitian
Other Registered Dietitian Providers in IMPERIAL, MO
| Name | Credential | NPI |
|---|---|---|
| MRS. EMILY ELIZABETH HAMMON | RD LD N | 1891491452 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.