Individual
NICHOLE ANGUILM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
3830 E VAN BUREN ST, PHOENIX, AZ 85008-6920
(602) 243-7277
(602) 286-0808
Mailing address
6943 E EARLL DR APT 6, SCOTTSDALE, AZ 85251-6877
(231) 670-6772
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86053094
AZ
133V00000X
Registered Dietitian
86053094
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173596
—
AZ
Enumeration date
06/16/2016
Last updated
04/05/2023
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