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Individual

MISS MAGGI JANE BIRDSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD, LDN

Contact information

Practice address
413 MCCONNELL ST, JEFFERSON, NC 28640-9772
(336) 246-9449
Mailing address
413 MCCONNELL ST, JEFFERSON, NC 28640-9772
(336) 246-9449

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L003257
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2991294A
MEDICARE PTAN
NC
Enumeration date
08/21/2009
Last updated
11/18/2016
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