Individual
JILL LOUISE BEZEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSRDN
Contact information
Practice address
8831 WALTHAM WOODS RD, PARKVILLE, MD 21234-2123
(410) 882-4620
Mailing address
1749 FORREST AVE, PARKVILLE, MD 21234-6115
(410) 802-6164
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
D00956
MD
133NN1002X
Nutrition Education Nutritionist
722570
IL
133V00000X
Registered Dietitian
722570
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3929051
—
MD
Enumeration date
03/27/2018
Last updated
03/27/2018
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