Provider Demographics
NPI:1306654942
Name:NICHOLS, KRISTEN BELCHER (RD)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:BELCHER
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 E HARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3043
Mailing Address - Country:US
Mailing Address - Phone:682-593-9369
Mailing Address - Fax:
Practice Address - Street 1:117 E HARWOOD RD
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3043
Practice Address - Country:US
Practice Address - Phone:682-593-9369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT07174133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered