Nikole Suzanne Barrett, R.D.N., C.D.
Individual provider Active NPI Registered Dietitian · Mishawaka, IN
NPI 1114129046 · NPPES record last updated Jul 27, 2014
Key facts
- NPI
- 1114129046
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 37001744A (IN)
- Practice address
- 229 E Omer Ave
Mishawaka, IN 46545-6345 - Phone
- (574) 217-8372
- NPI assigned
- Jun 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37001744A | IN | MD | Renal Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Live Well Nutrition, Inc. | Dietitian, Registered | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Renal Nutrition Registered Dietitian | 133VN1005X | 37001744A | IN | |
| Registered Dietitian | 133V00000X | 37001744A | IN | Yes |
Addresses
Primary practice location
229 E Omer Ave
Mishawaka, IN 46545-6345
Mailing address
229 E Omer Ave
Mishawaka, IN 46545-6345
Phone (574) 217-8372
Other providers in Mishawaka, IN
- Latisha Banks
- Olivia Larren Banks
- Jialin Bao
- Jody M Barber
- Lachelle L Barnett
- Barroso Therapy Services LLC
- Lacey Barroso
- Thomas Barry
- Jack S. Bartoszek
- Joseph John Bartush
All providers in Mishawaka, IN · Registered Dietitian in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.