Provider Demographics
NPI:1043644768
Name:SCOTT, ABBIE NICHOLE (RD, LD)
Entity type:Individual
Prefix:
First Name:ABBIE
Middle Name:NICHOLE
Last Name:SCOTT
Suffix:
Gender:
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6606 SW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50315-5429
Mailing Address - Country:US
Mailing Address - Phone:515-975-5707
Mailing Address - Fax:
Practice Address - Street 1:6606 SW 15TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50315-5429
Practice Address - Country:US
Practice Address - Phone:515-975-5707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3822133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered