=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508754813
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TAYLOR NICOLE WILLIAMS RDN, LDN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/25/2025
-----------------------------------------------------
Last Update Date | 06/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 22326 EXPLORATION DR
-----------------------------------------------------
City | LEXINGTON PARK
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20653-2020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-279-7989
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4401 TELFAIR BLVD APT 4427
-----------------------------------------------------
City | CAMP SPRINGS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20746-5294
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-501-7029
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number | DX7326
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------