Provider Demographics
NPI:1407544810
Name:HAYES, NICOLE (RDN)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30077 JOHNSON DR
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:MO
Mailing Address - Zip Code:65355-4412
Mailing Address - Country:US
Mailing Address - Phone:402-710-2437
Mailing Address - Fax:
Practice Address - Street 1:30077 JOHNSON DR
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:MO
Practice Address - Zip Code:65355-4412
Practice Address - Country:US
Practice Address - Phone:303-351-1675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered