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Theresa Renee Nickolaus, RD,LD,IBCLC
Registered Dietitian in Imperial, Missouri
NPI 1922774751

Theresa Renee Nickolaus is a Registered Dietitian based in Imperial, MO. Theresa Renee Nickolaus practices in Imperial, MO and has the professional credentials of RD,LD,IBCLC. The NPI Number for Theresa Renee Nickolaus is 1922774751 and holds a License No. L-124884 (Missouri).

The current practice location address for Theresa Renee Nickolaus is 1011 Scenic Oaks Ct, Imperial, MO and can be reached out via phone at 314-363-6186.

Location: 1011 Scenic Oaks Ct, Imperial, MO, 63052-3457
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1922774751
Provider Name
Theresa Renee Nickolaus
Credential
RD,LD,IBCLC
Provider Entity Type
Individual
Gender
Female
Address
1011 Scenic Oaks Ct, Imperial, MO, 63052-3457
Phone Number
314-363-6186
Fax Number
Provider Enumeration Date
08/20/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1011 Scenic Oaks Ct
City
Imperial
State
Missouri
Zip
63052-3457
Phone Number
314-363-6186
Fax Number
person
Provider Business Mailing Address Details
Address
1011 Scenic Oaks Ct
City
Imperial
State
Missouri
Zip
63052-3457
Phone Number
314-363-6186
Fax Number
person
Provider's Taxonomy Details 1
Type
Dietary & Nutritional Service Providers
Classification
Dietitian, Registered
Speciality
-
Taxonomy
133V00000X
License No.
2011041352 (Missouri)
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Lactation Consultant, Non-RN
Speciality
-
Taxonomy
174N00000X
License No.
L-124884 ()
Definition
An individual trained to provide breastfeeding assistance services to both mothers and infants. Lactation Consultants are not required to be nurses and are trained through specific courses of education. The Lactation Consultant may have additional certification through a national or international organization.
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