Provider Demographics
NPI:1770091522
Name:DURAND, JACQUELINE M (RD)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:M
Last Name:DURAND
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 LAKE HAYWARD RD
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415-1815
Mailing Address - Country:US
Mailing Address - Phone:860-705-4669
Mailing Address - Fax:
Practice Address - Street 1:214 LAKE HAYWARD RD
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415-1815
Practice Address - Country:US
Practice Address - Phone:860-705-4669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-15
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered