NPI 1104418672

Earnestine D Jackson, MSRDNLD

Practitioner Registered Dietitian Garland, TX

Practice location

Address: 250 N 5th St APT 2411, Garland, TX 75040-6355
Phone: (214) 417-3836

Registered specialties (5)

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence 86174756 (TX)

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Nutritionist

Dietary & Nutritional Service Providers Taxonomy 133N00000X

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Nutrition Education Nutritionist

Dietary & Nutritional Service Providers Taxonomy 133NN1002X

Obesity and Weight Management Nutrition Registered Dietitian

Dietary & Nutritional Service Providers Taxonomy 133VN1201X

Specialist

Other Service Providers Taxonomy 174400000X

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Registry record

NPI: 1104418672
Entity type: Individual
Sex (as registered): Female
NPI issued: 6 Feb 2021
Record last updated: 6 Feb 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.