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Individual

ONNIE BISHOP JORDAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDN, LD

Contact information

Practice address
145 11TH AVE NE, ST PETERSBURG, FL 33701-1823
(678) 478-1696
Mailing address
145 11TH AVE NE, ST PETERSBURG, FL 33701-1823
(678) 478-1696

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND7278
FL
133VN1005X
Renal Nutrition Registered Dietitian
ND7278
FL

Other

Enumeration date
12/21/2022
Last updated
12/21/2022
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