Doctor Name: | MS. PAMELA J NICHOLSON |
NPI Number: | 1033574967 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD, LDN |
License Number: | 164.000914 |
Business Practice Address: | 4500 Memorial Dr Belleville, IL - 622265360 |
Business Phone Number: | 6182574377 |
Business Fax Number: | 6182576616 |
Mailing Address: | 1 Elmbank Dr, BELLEVILLE |
State: | IL |
Postal Code: | 622264924 |
Phone Number: | 6184015361 |
Fax Number: | 6182576616 |
NPI Enumeration Date: | 12/18/2015 |
NPI Last Update Date: | 12/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 164.000914 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |