Individual
CAMERON MUNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1517A OSCEOLA ST, JACKSONVILLE, FL 32204-4305
(757) 284-6119
Mailing address
1517A OSCEOLA ST, JACKSONVILLE, FL 32204-4305
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7004
LICENSED DIETITIAN/NUTRITIONIST
FL
01
—
86025814
REGISTERED DIETITIAN NUTRITIONIST
—
Enumeration date
12/22/2018
Last updated
12/22/2018
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