Individual
KATELYN ROSE NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
1302 8TH AVE S, CLEAR LAKE, IA 50428-2610
(651) 302-9433
Mailing address
1302 8TH AVE S, CLEAR LAKE, IA 50428-2610
(651) 302-9433
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
079235
IA
Other
Enumeration date
04/15/2022
Last updated
04/15/2022
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