NPI 1508282153 · live from the CMS NPI Registry
Jordan Mccoy, MS, RD, RDN, CDCES
Dietitian, Registered in Ranchester, WY. National Provider Identifier 1508282153, active.
NPI record
| NPI | 1508282153 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 618 Heather Lane, Ranchester, WY 82839 |
| Practice phone | 307-752-7280 |
| Mailing address | Po Box 542, Dayton, WY 82836 |
| Enumerated | March 6, 2014 |
| Last updated | March 22, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 158 (WY) |
| Dietitian, Registered | 133V00000X | MED-NUTR-LIC-52027 (MT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.