Basic Information
| Provider Information | |||||||||
| NPI: | 1821753005 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GOLINSKI | ||||||||
| FirstName: | NICOLE | ||||||||
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| Credential: | RDN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1801 OLIVE CHAPEL RD STE 107 | ||||||||
| Address2: | |||||||||
| City: | APEX | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275028587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192675862 | ||||||||
| FaxNumber: | 9192675866 | ||||||||
| Practice Location | |||||||||
| Address1: | 1801 OLIVE CHAPEL RD STE 107 | ||||||||
| Address2: | |||||||||
| City: | APEX | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275028587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192675862 | ||||||||
| FaxNumber: | 9192675866 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2021 | ||||||||
| LastUpdateDate: | 11/04/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | L006657 | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.