Individual
MRS. NICOLE SHAY FENNELL
Active
Individual
MRS. NICOLE SHAY FENNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN, LD
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
133NN1002X
—
133V00000X
Registered Dietitian
Primary
133V00000X
TX
133VN1005X
Renal Nutrition Registered Dietitian
133VN1005X
—
133VN1006X
Metabolic Nutrition Registered Dietitian
113VN1006X
—
Other
Enumeration date
01/06/2012
Last updated
02/26/2020
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