Provider Demographics
NPI:1093588808
Name:CADY, NICOLE M (RD, LDN, CNSC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:M
Last Name:CADY
Suffix:
Gender:F
Credentials:RD, LDN, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 DEVYNN RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NC
Mailing Address - Zip Code:28120-7710
Mailing Address - Country:US
Mailing Address - Phone:860-201-7333
Mailing Address - Fax:
Practice Address - Street 1:128 DEVYNN RIDGE CT
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NC
Practice Address - Zip Code:28120-7710
Practice Address - Country:US
Practice Address - Phone:860-201-7333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004095133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered