Individual
MS. JILL ANN CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD, CDE
Contact information
Practice address
3593 E GRANDE BLVD, TYLER, TX 75707-1400
(903) 839-2585
Mailing address
3100 WILLIAMSBURG CIR, TYLER, TX 75701-6672
(903) 258-0357
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
887653
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133V00000X
COMMISSION OF DIETETIC REGISTRATION
—
01
—
20420056
CERTIFICATION BOARD FOR DIABETES CARE AND EDUCATION
—
Enumeration date
05/26/2022
Last updated
05/26/2022
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