Individual
MRS. JO ELLEN CONDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD, CDE
Contact information
Practice address
192A S SOUTHWOOD AVE, ANNAPOLIS, MD 21401-4026
(410) 487-2779
(410) 280-2278
Mailing address
192A S SOUTHWOOD AVE, ANNAPOLIS, MD 21401-4026
(410) 487-2779
(410) 280-2278
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DX2531
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
166237
NATIONAL CERTIFICATION BOARD FOR DIABETES EDUCATORS
—
01
—
725845
AMERICAN DIETETIC ASSOCIATION
—
01
—
787019
MEDICARE
MD
01
—
DX2531
MARYLAND STATE BOARD OF DIETETIC PRACTICE
MD
Enumeration date
01/05/2007
Last updated
05/07/2019
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