Nicole Konopka, ASN
Nutritionist in Apollo Beach, FL. Individual provider (NPI-1).
NPI number1053149591
StatusActive
Last updated in NPPESJul 25, 2024
Details
- NPI
- 1053149591
- Entity type
- Individual (NPI-1)
- Name
- Nicole Konopka
- Credential
- ASN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 25, 2024
- Certification date
- Jul 25, 2024
- Last updated
- Jul 25, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133N00000X | Nutritionist | – | – | Yes |
Practice location
7513 Lantern Park AveApollo Beach, FL 33572-1597
Phone 813-686-4732
Mailing address
7513 Lantern Park AveApollo Beach, FL 33572-1597
Phone 813-686-4732
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