Provider Demographics
NPI:1447458377
Name:NIX, RACHEL C (RD, CD, CLC)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:C
Last Name:NIX
Suffix:
Gender:F
Credentials:RD, CD, CLC
Other - Prefix:MISS
Other - First Name:RACHEL
Other - Middle Name:LYNNE
Other - Last Name:CUTTINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:439 W HAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-3617
Mailing Address - Country:US
Mailing Address - Phone:317-920-0661
Mailing Address - Fax:
Practice Address - Street 1:700 E SOUTHPORT RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-8546
Practice Address - Country:US
Practice Address - Phone:317-782-7525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN915379133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered