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Individual

MILLICENT TANNER

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
R.D.,C.D.E.

Contact information

Practice address
340 16TH AVE N, JACKSONVILLE BEACH, FL 32250-4819
(904) 247-1911
(904) 247-9736
Mailing address
340 16TH AVE N, JACKSONVILLE BEACH, FL 32250-4819
(904) 247-1911
(904) 247-9736

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Enumeration date
06/13/2006
Last updated
07/08/2007
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