MEDICARE: MARIA-LOURDES ARAGON NICHOLS RDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	1008638	CO

General Provider Information

NPI Number	:	1154635662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA-LOURDES ARAGON NICHOLS RDN

Provider Business Mailing Address
First Line	:	220 E MULBERRY ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3014
Country	:	US
Telephone Number	:	252-722-7367
Fax Number	:	877-832-8784

Provider Business Practice Location Address
First Line	:	3030 S COLLEGE AVE UNIT 210
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2557
Country	:	US
Telephone Number	:	253-722-7367
Fax Number	:	877-832-8784

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2010
Last Update Date	:	10/10/2025

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