NPI 1336465913

Beverly P Jackson, D

Practitioner Nutritionist Norwalk, CT

Practice location

Address: 19 Silk St, Norwalk, CT 06850-2916
Phone: (203) 962-2995

Registered specialties

Nutritionist Primary

Dietary & Nutritional Service Providers Taxonomy 133N00000X Licence ND00001 FEDERAL LIC.

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Registry record

NPI: 1336465913
Entity type: Individual
Sex (as registered): Female
NPI issued: 8 Apr 2010
Record last updated: 12 Jun 2016

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.