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Individual

JACKIE R GRIFFITHS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD,LN

Contact information

Practice address
4474 23RD AVE S STE M, FARGO, ND 58104-8795
(701) 282-2635
Mailing address
105 EVERGREEN CIR, WEST FARGO, ND 58078-1201
(701) 866-9352

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
736
ND
133VN1005X
Renal Nutrition Registered Dietitian
Primary
736
ND

Other

Enumeration date
01/03/2008
Last updated
01/03/2008
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