Provider Demographics
NPI:1033596887
Name:NELSON, MOLLY NEEB (RD, RDN)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:NEEB
Last Name:NELSON
Suffix:
Gender:F
Credentials:RD, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 9TH AVE SW
Mailing Address - Street 2:ATTN: BUSINESS OFFICE
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-4527
Mailing Address - Country:US
Mailing Address - Phone:205-481-7183
Mailing Address - Fax:205-481-8435
Practice Address - Street 1:995 9TH AVE SW
Practice Address - Street 2:ATTN: BUSINESS OFFICE
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-4527
Practice Address - Country:US
Practice Address - Phone:205-481-7183
Practice Address - Fax:205-481-8435
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2504133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered