Individual
MS. PAMELA J NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
4500 MEMORIAL DR, BELLEVILLE, IL 62226-5360
(618) 257-4377
(618) 257-6616
Mailing address
1 ELMBANK DR, BELLEVILLE, IL 62226-4924
(618) 401-5361
(618) 257-6616
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.000914
IL
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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