Holly Olivio, MS, RDN, LDN, CNSC

Individual provider Active NPI Registered Dietitian · Moweaqua, IL

NPI 1508613332 · NPPES record last updated Apr 30, 2024

Key facts

NPI
1508613332
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
164007162 (IL)
Practice address
337 N Hanover St
Moweaqua, IL 62550-1025
Phone
(217) 820-9380
NPI assigned
Apr 30, 2024
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
164007162ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 164007162 IL Yes

Addresses

Primary practice location

337 N Hanover St
Moweaqua, IL 62550-1025

Mailing address

337 N Hanover St
Moweaqua, IL 62550-1025
Phone (217) 820-9380

Other practice location 1

3724 Jefferson St Ste 104
Austin, TX 78731-6204
Phone (512) 692-7045

Other providers in Moweaqua, IL

All providers in Moweaqua, IL · Registered Dietitian in Illinois

Sources for this page

Verify at the official NPI Registry.