Individual
MICHELLE JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
400 HEALTH PARK BLVD, NUTRITION SERVICES, ST AUGUSTINE, FL 32086-5784
(904) 819-4404
(904) 819-4936
Mailing address
400 HEALTH PARK BLVD, NUTRITION SERVICES, ST AUGUSTINE, FL 32086-5784
(904) 819-4404
(904) 819-4936
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
5738
FL
133V00000X
Registered Dietitian
5738
FL
Other
Enumeration date
08/20/2010
Last updated
08/20/2010
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