Active NPI 1073089934 Individual Practitioner Female Practitioner

Nicole Kristina Derse , CNC

Nutritionist • Appleton, WI

Professional Overview & Biography Verified Profile Summary

Nicole Derse, CNC is a registered healthcare professional specializing in Nutritionist in Appleton, WI. Practice services are available at 308 E GLENDALE AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

308 E Glendale Ave

Appleton, WI 549112907

Telephone 9203225115

Specialty Benchmarks & Practice Insights

Comparative analytics for Nutritionist in Appleton, WI

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 2.0 Yrs

Regional Practice Density

1 Specialists

Practicing in Appleton, WI (38 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Nutritionist Primary Specialty

NUCC Taxonomy Code: 133N00000X

State License WI 12D577516

A specialist in adapting and applying food and nutrient knowledge to the solution of food and nutritional problems, the control of disease, and the promotion of health. Nutritionists perform research, instruct groups and individuals about nutritional requirements, and assist people in developing meal patterns that meet their nutritional needs; (2) A nutritionist is someone who has completed undergraduate and/or graduate training in the discipline of nutrition without necessarily meeting the academic and experience requirements to qualify for the Registered Dietitian designation.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active October 18, 2018

NPI status registered as active in NPPES database

📍

Updated Practice Location October 18, 2018

Registered at 308 E GLENDALE AVE, APPLETON, WI 549112907 (Tel: 9203225115)

📍

Updated Business Mailing Address October 18, 2018

Registered at 308 E GLENDALE AVE, APPLETON, WI 549112907 (Tel: 9203225115)

👤

Provider Name / Credentials Updated October 18, 2018

Recorded as NICOLE DERSE, CNC

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 18, 2018

Nutritionist (License #12D577516 in WI)

🟢

Initial NPI Registration & Enumeration October 18, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1073089934

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 18, 2018

Last Update: October 18, 2018

Sole Proprietor: No

Update or Correct Profile

Mailing Address

308 E Glendale Ave

Appleton, WI 549112907

Phone: 9203225115

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.