Individual
STEPHANIE ALYSON NICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, CLC
Contact information
Practice address
501 AIRPORT RD, RIFLE, CO 81650-8510
(970) 625-6200
Mailing address
501 AIRPORT RD, RIFLE, CO 81650-8510
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
86133338
CO
174N00000X
Lactation Consultant (Non-RN)
Primary
316228
CO
Other
Enumeration date
11/08/2022
Last updated
11/08/2022
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