Provider Demographics
NPI:1821795865
Name:MURRAY, JAZMIN (MPH, RDN, LDN)
Entity Type:Individual
Prefix:
First Name:JAZMIN
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MPH, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3066 BRUCKNER BLVD
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2710
Mailing Address - Country:US
Mailing Address - Phone:413-328-3515
Mailing Address - Fax:
Practice Address - Street 1:3066 BRUCKNER BLVD
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2710
Practice Address - Country:US
Practice Address - Phone:413-328-3515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA86167294133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered