Individual provider · NPI-1

Nicole Antes, RD

Dietitian, Registered · Glendale, AZ

NPI number1356042535
StatusActive
Last updated in NPPESMar 14, 2023

Details

NPI
1356042535
Entity type
Individual (NPI-1)
Name
Nicole Antes
Credential
RD
Sex
Female
Sole proprietor
No
Enumeration date
Mar 14, 2023
Certification date
Mar 14, 2023
Last updated
Mar 14, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, Registered86294431AZYes

Practice location

18001 N 79th Ave Ste A12
Glendale, AZ 85308-8398

Phone 623-399-6825 · Fax 623-505-3474

Mailing address

18001 N 79th Ave Ste A12
Glendale, AZ 85308-8398

Phone 623-399-6825 · Fax 623-505-3474

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