Individual
TAMIKA FORKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
120 DISTRICT BLVD APT 510, JACKSON, MS 39211-6392
(601) 954-2837
Mailing address
120 DISTRICT BLVD APT 510, JACKSON, MS 39211-6392
(601) 954-2837
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D1327
MS
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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