Individual
JORDAN STILMOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CLC, LMNT
Contact information
Practice address
810 N 22ND ST, BLAIR, NE 68008-1128
(402) 426-1232
Mailing address
810 N 22ND ST, BLAIR, NE 68008-1128
(402) 426-1232
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86033344
NE
174N00000X
Lactation Consultant (Non-RN)
ALPP-251862
NE
Other
Enumeration date
05/30/2017
Last updated
07/21/2022
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