Healthcare Provider Details

I. General information

NPI: 1104731355
Provider Name (Legal Business Name): NOMADIQ RD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 E MICHIGAN ST UNIT 3905
MILWAUKEE WI
53202-5661
US

IV. Provider business mailing address

909 E MICHIGAN ST UNIT 3905
MILWAUKEE WI
53202-5661
US

V. Phone/Fax

Practice location:
  • Phone: 414-406-3335
  • Fax:
Mailing address:
  • Phone: 414-406-3335
  • 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: CHRISTOPHER JOHN NAYLOR
Title or Position: CO-OWNER & PRACTICE ADMINISTRATOR
Credential:
Phone: 316-648-0285