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General NPI Number Information
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NPI Number | 1568421527
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Entity Type | Individual
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Provider Name | NIKKI LYNN ANDERSON RD, CDE, LD
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Gender | Female
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 494 HUB BLVD APT 218
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City | BOWLING GREEN
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State | KY
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Zip | 42103-8921
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Country | US
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Telephone | 270-748-7608
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Fax | 270-748-7608
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Provider Business Mailing Address
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Address Line | 494 HUB BLVD APT 218
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City | BOWLING GREEN
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State | KY
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Zip | 42103-8921
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Country | US
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Telephone | 270-748-7608
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Fax | 270-748-7608
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1700
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 2332
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DN006969
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | 20720185
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DT86701
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 37003099A
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License Number State | IN
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