Individual
JESSICA THEOBALD SEYMOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NUTRITIONIST
Contact information
Practice address
324 N QUEEN ST, KINSTON, NC 28501-4932
(252) 522-9485
Mailing address
324 N QUEEN ST, KINSTON, NC 28501-4932
(252) 522-9485
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
L001943
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L001943
NUTRITIONIST LICENSE
NC
Enumeration date
09/25/2006
Last updated
07/08/2007
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