Individual
MS. LISA JAYNE MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
1117 2ND ST, GULFPORT, MS 39501-2205
(601) 297-5099
Mailing address
1117 2ND ST, GULFPORT, MS 39501-2205
(601) 297-5099
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
133V00000X
MS
Other
Enumeration date
04/07/2015
Last updated
09/08/2025
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