MS. NICOLE KRISTINA DERSE (NPI# 1073089934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073089934 |
| Entity Type | Individual |
| Full Name | MS. NICOLE KRISTINA DERSE |
| Other Name | NICOLE JAMES |
| Credential | CNC |
| Practice Address |
308 E Glendale Ave Appleton WI 54911-2907 |
| Practice Telephone | 9203225115 |
| Mailing Telephone | 9203225115 |
| Enumeration Date | 2018-10-18 |
| Last Update Date | 2018-10-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133N00000X | Nutritionist | 12D577516 | WI | Dietary & Nutritional Service Providers |
| Street Address |
308 E GLENDALE AVE |
| City | APPLETON |
| State | WI |
| Zip Code | 54911-2907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912545633 | Brotherly Love, LLC | Day Training, Developmentally Disabled Services | 1513 E Frances St, Appleton, WI 54911 | 2019-12-12 |
| 1952952129 | Eagle Point Senior Living Inc | Assisted Living Facility | 995 East John Street, Appleton, WI 54911 | 2019-09-27 |
| 1619524766 | University Rx LLC | Pharmacy | 133 E College Ave, Appleton, WI 54911 | 2019-08-23 |
| 1174080063 | Shayla Russell | Counselor | Outagamie County Health and Human Services, 320 S. Walnut St., Appleton, WI 54911 | 2019-02-27 |
| 1871086645 | Megan Kilsdonk | Health Educator | 1604 N Meade St, Appleton, WI 54911 | 2018-06-07 |
| 1871085480 | Tanya Lynn Vickery | Social Worker | 410 S. Elm St., Appleton, WI 54911 | 2018-05-31 |
| 1013407501 | Teri G Metropulos | Counselor | 229 S. Morrison, Appleton, WI 54911 | 2018-05-10 |
| 1093211211 | Bonnie Anne Korytkowski | Student in an Organized Health Care Education/Training Program | 229 S. Morrison Street, Appleton, WI 54911 | 2018-04-05 |
| 1639673940 | Brett Follett | Psychologist | 401 S. Elm St., Appleton, WI 54911 | 2018-03-21 |
| 1700202892 | Brian Withrow | Counselor | 607 West 7th St., Appleton, WI 54911 | 2014-03-13 |
| Find all providers in zip 54911 | ||||
| Taxonomy Code | 133N00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Nutritionist |
| A specialist in adapting and applying food and nutrient knowledge to the solution of food and nutritional problems, the control of disease, and the promotion of health. Nutritionists perform research, instruct groups and individuals about nutritional requirements, and assist people in developing meal patterns that meet their nutritional needs; (2) A nutritionist is someone who has completed undergraduate and/or graduate training in the discipline of nutrition without necessarily meeting the academic and experience requirements to qualify for the Registered Dietitian designation. |
| Notes: Source: (1) Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861019804 | Thomas Jack Sampson | Nutritionist | 2021 Broadway St S, Menomonie, WI 54751-3950 | 2020-06-25 |
| 1922624469 | Brianna Mesenbring | Nutritionist | 3565 Willow Dr Apt 132, Plover, WI 54467-3590 | 2020-06-21 |
| 1073149191 | Angela Quinn Riederer | Nutritionist | 301 S Blount St, Madison, WI 53703-4664 | 2020-03-20 |
| 1962927434 | Eileen Cheryl Schutte | Nutritionist | 117 Paradise Ct, Deforest, WI 53532-1787 | 2017-08-07 |
| 1053652602 | Jaime L Popenhagen | Nutritionist | 112 Elizabeth Ln, Genoa City, WI 53128-2124 | 2013-03-06 |
| 1720330517 | Tricia Paulson | Nutritionist | 708 Chieftain St, Osceola, WI 54020-8016 | 2012-10-04 |
| 1144527797 | Susan E Barendregt | Nutritionist | 114 Fs Dr, Suite A, Viroqua, WI 54665-6202 | 2011-02-17 |
| 1053622746 | Karen Sue Tait I | Nutritionist | 434 W River Front Dr, Glendale, WI 53217-4459 | 2010-06-28 |
| 1992910343 | Camilla Mcintosh-rahn | Nutritionist | 1426 Oakdale Dr, Waukesha, WI 53189-7204 | 2007-05-11 |
| 1346372919 | Susan J Lorentzen | Nutritionist | 9130 W Loomis Rd, Suite 900, Franklin, WI 53132-8888 | 2007-03-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.