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Individual

EARNESTINE D JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, RDN, LD

Contact information

Practice address
250 N 5TH ST APT 2411, GARLAND, TX 75040-6355
(214) 417-3836
Mailing address
250 N 5TH ST APT 2411, GARLAND, TX 75040-6355
(214) 417-3836

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
133NN1002X
Nutrition Education Nutritionist
133V00000X
Registered Dietitian
Primary
86174756
TX
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
174400000X
Specialist

Other

Enumeration date
02/06/2021
Last updated
02/06/2021
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