Provider Demographics
NPI:1336514025
Name:POPOVSKA, JASMINA (RDN)
Entity Type:Individual
Prefix:
First Name:JASMINA
Middle Name:
Last Name:POPOVSKA
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 YPAO ROAD
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GUAM
Mailing Address - Zip Code:96913
Mailing Address - Country:UM
Mailing Address - Phone:671-646-8881
Mailing Address - Fax:
Practice Address - Street 1:YPAO ROAD
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GUAM
Practice Address - Zip Code:96913
Practice Address - Country:UM
Practice Address - Phone:671-646-8881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-06
Last Update Date:2015-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GU000031133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered