Provider Demographics
NPI:1528588738
Name:NYHOLM, JOSEPH (RD)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:NYHOLM
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1832
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:AK
Mailing Address - Zip Code:99664-1832
Mailing Address - Country:US
Mailing Address - Phone:907-362-7729
Mailing Address - Fax:
Practice Address - Street 1:1840 BRAGAW ST STE 110
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3463
Practice Address - Country:US
Practice Address - Phone:907-224-3076
Practice Address - Fax:907-362-7729
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered