Individual
JACQUELINE PATRICIA DZIUBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, LDN
Contact information
Practice address
517 MOYE BLVD, GREENVILLE, NC 27834-2849
(252) 744-2832
(252) 744-3457
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L005149
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2057J
BCBS OF NC
NC
01
—
Q65387A
MEDICARE
NC
Enumeration date
08/19/2019
Last updated
08/02/2022
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