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General NPI Number Information
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NPI Number | 1376803700
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Entity Type | Individual
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Provider Name | NICHOLE L. HAYNES MS, RD, CSR, LDN
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Gender | Female
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Dates
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Enumeration Date | 05/18/2012
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Last Update Date | 05/18/2012
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Provider Practice Location Address
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Address Line | 242 ORLANDO AVE
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City | NASHVILLE
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State | TN
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Zip | 37209-3246
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Country | US
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Telephone | 615-354-0053
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Fax | 615-354-1809
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Provider Business Mailing Address
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Address Line | 107 ANTLER RIDGE CIR
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City | NASHVILLE
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State | TN
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Zip | 37214-4743
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Country | US
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Telephone | 615-513-3131
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Fax | 615-354-1809
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1005X
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Taxonomy Name | Renal Nutrition Registered Dietitian
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License Number | 1486
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License Number State | TN
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