Provider Demographics
NPI:1598646002
Name:MCMULLEN, JACINDA CHRISTINE (RD)
Entity type:Individual
Prefix:
First Name:JACINDA
Middle Name:CHRISTINE
Last Name:MCMULLEN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:JACINDA
Other - Middle Name:CHRISTINE
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:210 ANDERSON DR
Mailing Address - Street 2:
Mailing Address - City:MARY ESTHER
Mailing Address - State:FL
Mailing Address - Zip Code:32569-1804
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:210 ANDERSON DR
Practice Address - Street 2:
Practice Address - City:MARY ESTHER
Practice Address - State:FL
Practice Address - Zip Code:32569-1804
Practice Address - Country:US
Practice Address - Phone:856-236-4996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered