Nina Killie Mickle | Washington, DC • PECOS Search

Nina Killie Mickle

Dietitian, Registered

Dietary & Nutritional Service Providers

111 Michigan Ave NW, Washington, DC 20010-2916

PECOS Enrollment

Based on the most recent information from CMS, provider Nina Killie Mickle does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1295382844
Provider Type
Individual
Full Name
Mickle, Nina Killie
Title
Mrs.
Credential
MS, RD

Gender
Female
Sole Proprietor
No
Enumeration Date
8/19/2019
Last Updated
8/19/2019

Contact Information

Practice Location

111 Michigan Ave NW, Washington, DC 20010-2916

Unlisted Fax

Mailing Location

1516 N Stafford St Apt B, Arlington, VA 22207-3108

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 133V00000X Primary	Description Dietitian, Registered Dietary & Nutritional Service Providers	License Unlisted Issuer