Provider Demographics
NPI:1356813422
Name:ARRUDA, NICOLE (RD LDN)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:ARRUDA
Suffix:
Gender:F
Credentials:RD LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 LAFAYETTE DR
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-5012
Mailing Address - Country:US
Mailing Address - Phone:401-855-6933
Mailing Address - Fax:
Practice Address - Street 1:47 LAFAYETTE DR
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:RI
Practice Address - Zip Code:02809-5012
Practice Address - Country:US
Practice Address - Phone:401-855-6933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-29
Last Update Date:2018-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered