Provider Demographics
NPI:1902513872
Name:FRANKLIN, NICOLE (RDN, CSO, LDN)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:
Credentials:RDN, CSO, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 749495
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9495
Mailing Address - Country:US
Mailing Address - Phone:855-963-2100
Mailing Address - Fax:813-321-1296
Practice Address - Street 1:3220 MCMULLEN BOOTH ROAD
Practice Address - Street 2:SUITE C
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2012
Practice Address - Country:US
Practice Address - Phone:727-223-7485
Practice Address - Fax:727-260-6273
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
NC86029394133VN1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1301XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Oncology
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered