Provider Demographics
NPI:1265746333
Name:ANDREWS, NICOLE (RD, LD/N)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 NE 34TH CT
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1022
Mailing Address - Country:US
Mailing Address - Phone:954-205-2334
Mailing Address - Fax:
Practice Address - Street 1:1840 NE 34TH CT
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33306-1022
Practice Address - Country:US
Practice Address - Phone:954-205-2334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-01
Last Update Date:2010-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND4739133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered