NPI 1689294829 · live from the CMS NPI Registry
Jennifer K Jackson, MPH, RDN
Dietitian, Registered in Albuquerque, NM. National Provider Identifier 1689294829, active.
NPI record
| NPI | 1689294829 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 13017 Bear Dancer Trl Ne, Albuquerque, NM 87112 |
| Practice phone | 505-301-0384 |
| Enumerated | April 17, 2020 |
| Last updated | April 17, 2020 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | LD-1334 (NM) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.