1. Home
  2. Directory
  3. Missouri
  4. Imperial
  5. Dietitian Registered
  6. NPI Profile

THERESA RENEE NICKOLAUS RD, LD, IBCLC
NPI 1922774751
Dietitian, Registered in Imperial, MO

Active since August 20, 2021
1011 SCENIC OAKS CT, IMPERIAL, MO 63052(314) 363-6186 Get Directions Write a Review

NPPES record last updated: August 20, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Theresa Renee Nickolaus Rd, Ld, Ibclc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THERESA RENEE NICKOLAUS RD, LD, IBCLC (NPI 1922774751) is an individual dietitian, registered in Imperial, Missouri, licensed in Missouri (2011041352) and active in the NPI registry since August 2021.

NPPES Registry Identity

NPI1922774751
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameTHERESA RENEE NICKOLAUSCredential: RD, LD, IBCLC
Location Address1011 SCENIC OAKS CTImperial, MO 63052-3457
Mailing Address1011 Scenic Oaks CtImperial, MO 63052-3457 · (314) 363-6186
Phone(314) 363-6186
Sole ProprietorYes
Enumeration DateAugust 20, 2021
NPPES CertifiedAugust 20, 2021
✔ NPI 1922774751 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in MO · 2011041352
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
Also ListedLactation Consultant, Non-RNTaxonomy 174N00000X · License L-124884
1011 SCENIC OAKS CT, Imperial, MO 63052
Open in Google Maps ↗

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theresa Nickolaus's NPI number?

The NPI number for Theresa Nickolaus is 1922774751. It was assigned to this individual provider in the NPPES registry on August 20, 2021.

Where is Theresa Nickolaus located?

Theresa Nickolaus practices at 1011 Scenic Oaks Ct, Imperial, MO 63052. The listed phone number is (314) 363-6186.

What is Theresa Nickolaus's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

When was this NPI record last updated?

The NPPES record for Theresa Nickolaus was last updated on August 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.