Provider Demographics
NPI:1629808241
Name:MUMBEY, JOANNE FRANCES (RDN)
Entity type:Individual
Prefix:
First Name:JOANNE FRANCES
Middle Name:
Last Name:MUMBEY
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 1:3611 DARTMOUTH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-7543
Mailing Address - Country:US
Mailing Address - Phone:813-501-2207
Mailing Address - Fax:
Practice Address - Street 1:3611 DARTMOUTH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-7543
Practice Address - Country:US
Practice Address - Phone:813-501-2207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00892101133V00000X
FLND8509133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered