Individual
JESSICA IVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Contact information
Practice address
5653 FRIST BLVD STE 530, HERMITAGE, TN 37076-2067
(214) 789-7233
Mailing address
3404 DAKOTA AVE, NASHVILLE, TN 37209-3905
(214) 789-7233
(833) 453-1596
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3139
TN
Other
Enumeration date
07/20/2018
Last updated
07/05/2022
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