Provider Demographics
NPI:1881254183
Name:MYERS, JULIA M (RDN, LD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:M
Last Name:MYERS
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:M
Other - Last Name:BAZE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1530 US HIGHWAY 43
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35594-5056
Mailing Address - Country:US
Mailing Address - Phone:205-487-7758
Mailing Address - Fax:
Practice Address - Street 1:1530 US HIGHWAY 43
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594-5056
Practice Address - Country:US
Practice Address - Phone:205-487-7758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1884133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered