Provider Demographics
NPI:1154674208
Name:STRICKLAND, JESSICA (MS, RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 OLD HICKORY BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2562
Mailing Address - Country:US
Mailing Address - Phone:731-661-2750
Mailing Address - Fax:731-664-6817
Practice Address - Street 1:180 OLD HICKORY BLVD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2562
Practice Address - Country:US
Practice Address - Phone:731-661-2750
Practice Address - Fax:731-664-6817
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1792133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered