Individual
NICOLE WYNNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
200 EDIE ANN DR, LAFAYETTE, LA 70508-5325
(337) 739-0293
Mailing address
200 EDIE ANN DR, LAFAYETTE, LA 70508-5325
(337) 739-0293
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1770
LA
Other
Enumeration date
08/25/2008
Last updated
08/25/2008
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