Provider Demographics
NPI:1679136188
Name:NYKTAS, ANNE CHRISTINE (RDN, LDN)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:CHRISTINE
Last Name:NYKTAS
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4104 BACH-BUXTON ROAD
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103
Mailing Address - Country:US
Mailing Address - Phone:513-943-5050
Mailing Address - Fax:
Practice Address - Street 1:4104 BACH-BUXTON ROAD
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103
Practice Address - Country:US
Practice Address - Phone:513-943-5050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-19
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD3258133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered