Healthcare Provider Details

I. General information

NPI: 1881210649
Provider Name (Legal Business Name): NIKKI JUPE NUTRITION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2020
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5995 W HAMPDEN AVE UNIT I13
DENVER CO
80227-5486
US

IV. Provider business mailing address

5995 W HAMPDEN AVE UNIT I13
DENVER CO
80227-5486
US

V. Phone/Fax

Practice location:
  • Phone: 254-366-9204
  • Fax:
Mailing address:
  • Phone: 254-366-9204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133VN1501X
TaxonomySports Dietetics Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: NIKKI JUPE
Title or Position: OWNER
Credential: REGISTERED DIETITIAN
Phone: 254-366-9204