Provider Demographics
NPI:1972112613
Name:NICHOLS, RACHEL CREECH (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:CREECH
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 BLACKWATER LN
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-7836
Mailing Address - Country:US
Mailing Address - Phone:803-687-0637
Mailing Address - Fax:
Practice Address - Street 1:106 BLACKWATER LN
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-7836
Practice Address - Country:US
Practice Address - Phone:803-870-6376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLRD.2085.RD133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered