Healthcare Provider Details

I. General information

NPI: 1245547389
Provider Name (Legal Business Name): NICOLE CELONA-JACOBS M.S. R.D. CDE.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2010
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6725 S CROCKER WAY
LITTLETON CO
80120-3659
US

IV. Provider business mailing address

6725 S CROCKER WAY STE 410
LITTLETON CO
80120-3659
US

V. Phone/Fax

Practice location:
  • Phone: 720-966-9136
  • Fax:
Mailing address:
  • Phone: 720-966-9136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: