Individual
MRS. JESSICA LYNN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD/LD
Contact information
Practice address
1551 NORTH OAKLAND, BOLIVAR, MO 65613
(417) 328-6737
(417) 328-6749
Mailing address
1551 NORTH OAKLAND, BOLIVAR, MO 65613
(417) 328-6737
(417) 328-6749
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2009029528
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
350103800
—
MO
Enumeration date
10/08/2009
Last updated
10/08/2009
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