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Contact Information

NIKOLE LARSON, RD
1719 MAGNOLIA WAY
AUGUSTA, GA30909-9482
 Phone: 706-825-4944
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nutrition, Renal

133VN1005X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for NIKOLE LARSON · (Female)

NPI Number 1962826560
Status Active
Credentials RD (Registered Dietitian)
Entity Individual
Enumeration date 02/18/2014
Last updated 02/18/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • GA License # LD002687
  • SC License # 825
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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