Provider Demographics
NPI:1295144483
Name:ESTES, EMILY N (MS, RD, LMNT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:N
Last Name:ESTES
Suffix:
Gender:F
Credentials:MS, RD, LMNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 O ST STE B2
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68508-3626
Mailing Address - Country:US
Mailing Address - Phone:402-340-3050
Mailing Address - Fax:866-883-1742
Practice Address - Street 1:941 O ST
Practice Address - Street 2:SUITE B-2
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-3608
Practice Address - Country:US
Practice Address - Phone:402-340-3050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-13
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1149133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered