Provider Demographics
NPI:1649242116
Name:VALLEE, NICOLE (RD, LDN)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:VALLEE
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:LEFEBVRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:605 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-1901
Mailing Address - Country:US
Mailing Address - Phone:508-856-0104
Mailing Address - Fax:508-856-7425
Practice Address - Street 1:WOMACK ARMY MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-0001
Practice Address - Country:US
Practice Address - Phone:910-907-7866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002678133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered