Provider Demographics
NPI:1609664531
Name:NICOLETTE, SARAH L (RD, LDN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:NICOLETTE
Suffix:
Gender:
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 NOVA CT
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-1907
Mailing Address - Country:US
Mailing Address - Phone:865-243-5881
Mailing Address - Fax:
Practice Address - Street 1:609 NOVA CT
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-1907
Practice Address - Country:US
Practice Address - Phone:865-243-5881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN0000004677133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered