Individual
JESSE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDN, LD
Contact information
Practice address
234 GOODWIN CREST DR, HOMEWOOD, AL 35209-3701
(205) 290-4567
(205) 943-4987
Mailing address
234 GOODWIN CREST DR, HOMEWOOD, AL 35209-3701
(205) 290-4567
(205) 943-4987
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3352
AL
133V00000X
Registered Dietitian
86254087
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3352
ALABAMA BOARD OF EXAMINERS FOR DIETETICS AND NUTRITION
AL
01
—
86254087
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
02/21/2023
Last updated
02/21/2023
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