Provider Demographics
NPI:1437639028
Name:HINCKLEY, NICOLE E (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:E
Last Name:HINCKLEY
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 1:1809 GREEN TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-6036
Mailing Address - Country:US
Mailing Address - Phone:972-742-7468
Mailing Address - Fax:
Practice Address - Street 1:1701 ELDORADO PKWY STE 202
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-8069
Practice Address - Country:US
Practice Address - Phone:214-702-8850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT85465133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered