Provider Demographics
NPI:1639341928
Name:JACOBS-HIGDON, JULIE M (RD / LDN)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:M
Last Name:JACOBS-HIGDON
Suffix:
Gender:F
Credentials:RD / LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4234 AG RD
Mailing Address - Street 2:
Mailing Address - City:GROVELAND
Mailing Address - State:FL
Mailing Address - Zip Code:34736-9426
Mailing Address - Country:US
Mailing Address - Phone:407-446-3018
Mailing Address - Fax:
Practice Address - Street 1:4234 AG RD
Practice Address - Street 2:
Practice Address - City:GROVELAND
Practice Address - State:FL
Practice Address - Zip Code:34736-9426
Practice Address - Country:US
Practice Address - Phone:407-446-3018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL279133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered