Individual
NICOLE BARNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CD
Contact information
Practice address
1205 BROOKDALE DRIVE, BOZEMAN, MT 59715
(425) 591-1136
Mailing address
1205 BROOKDALE DRIVE, BOZEMAN, MT 59715
(425) 591-1136
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
106335
MT
133V00000X
Registered Dietitian
DI60190595
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
963106
RD CERTIFICATION
WA
01
—
DI60190595
STATE LICENSE
WA
Enumeration date
11/04/2011
Last updated
05/10/2022
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