Provider Demographics
NPI:1851407407
Name:MIDKIFF, JOY DOROTHEA (MS, RDN, LDN)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:DOROTHEA
Last Name:MIDKIFF
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 CHICKADEE DR
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-4722
Mailing Address - Country:US
Mailing Address - Phone:614-425-6795
Mailing Address - Fax:
Practice Address - Street 1:330 N CLYDE MORRIS BLVD STE 9
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-2733
Practice Address - Country:US
Practice Address - Phone:386-676-7133
Practice Address - Fax:386-238-3228
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3277133V00000X
FLND6311133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered