Individual
MRS. OLIVIA ANN NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
711 MARSHALL ST, LEAVENWORTH, KS 66048-3235
(913) 684-1196
Mailing address
826 S 14TH ST APT 208, SAINT JOSEPH, MO 64501-4301
(308) 470-1218
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2173
KS
Other
Enumeration date
06/02/2017
Last updated
06/02/2017
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