Individual
JESSICA ANN SISNEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
101 HEART DR, GREENVILLE, NC 27834-8982
(252) 744-4611
(252) 744-3201
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L003922
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19FTZ
BCBS OF NC
NC
Enumeration date
10/16/2015
Last updated
05/06/2016
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