Provider Demographics
NPI:1952877185
Name:HINKLEY, JESSICA JULIA (RD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:JULIA
Last Name:HINKLEY
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 1:1747 S DEFRAME ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-4179
Mailing Address - Country:US
Mailing Address - Phone:570-850-1868
Mailing Address - Fax:
Practice Address - Street 1:1747 S DEFRAME ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-4179
Practice Address - Country:US
Practice Address - Phone:570-850-1868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty