Provider Demographics
NPI:1154635662
Name:NICHOLS, MARIA-LOURDES ARAGON (RDN)
Entity Type:Individual
Prefix:
First Name:MARIA-LOURDES
Middle Name:ARAGON
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:MARIA-LOURDES
Other - Middle Name:VILLAVIRAY
Other - Last Name:ARAGON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:220 E MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3014
Mailing Address - Country:US
Mailing Address - Phone:252-722-7367
Mailing Address - Fax:877-832-8784
Practice Address - Street 1:220 E MULBERRY ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3014
Practice Address - Country:US
Practice Address - Phone:253-722-7367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA01008638133V00000X
WA1008638133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist