Doctor Name: | JESSICA BEACOM |
NPI Number: | 1750460572 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 886309 |
Business Practice Address: | 202 Prospect Dr Glendive, MT - 593301943 |
Business Phone Number: | 4063453388 |
Business Fax Number: | 4063453358 |
Mailing Address: | 202 Prospect Dr, GLENDIVE |
State: | MT |
Postal Code: | 593301943 |
Phone Number: | 4063453388 |
Fax Number: | 4063453358 |
NPI Enumeration Date: | 11/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 886309 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |