Provider Demographics
NPI:1841151651
Name:DIX, JESSICA JENNIE (RD)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:JENNIE
Last Name:DIX
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 1:1683 STATE HIGHWAY 8
Mailing Address - Street 2:
Mailing Address - City:MOUNT UPTON
Mailing Address - State:NY
Mailing Address - Zip Code:13809-4106
Mailing Address - Country:US
Mailing Address - Phone:607-643-5407
Mailing Address - Fax:
Practice Address - Street 1:1683 STATE HIGHWAY 8
Practice Address - Street 2:
Practice Address - City:MOUNT UPTON
Practice Address - State:NY
Practice Address - Zip Code:13809-4106
Practice Address - Country:US
Practice Address - Phone:607-463-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-20
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered