MEDICARE: JACKIE LYNN DALZELL RD, LDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	L003957	NC

General Provider Information

NPI Number	:	1316461791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACKIE LYNN DALZELL RD, LDN

Provider Business Mailing Address
First Line	:	2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	910-907-8922
Fax Number	:

Provider Business Practice Location Address
First Line	:	2817 ROCK MERRITT AVE
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-6162
Country	:	US
Telephone Number	:	910-907-8922
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2017
Last Update Date	:	08/05/2025

Similar Medicare Providers

1003036047 — MRS. SEKEYA EDREEKIA DURGAN NP
Practice Location Address:

2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER
FORT BRAGG, NC
28310-6162

Practice Phone: 910-907-8922
Practice Fax:

1023965332 — JARICE HELPING HAND LLC
Practice Location Address:

5624 MARTYS HILL PL
FORT WAYNE, IN
46815-6162

Practice Phone: 260-210-7932
Practice Fax:

1548009806 — UPSIDEHOM, INC.
Practice Location Address:

6365 NW 6TH WAY STE 200
FORT LAUDERDALE, FL
33309-6162

Practice Phone: 954-231-4119
Practice Fax:

1891101010 — DR. RACHEL STEELE PHD
Practice Location Address:

2817 ROCK MERRITT AVENUE
FORT BRAGG, NC
28310-5000

Practice Phone: 910-907-8707
Practice Fax:

1972861045 — MS. JENNIFER ANN TIFFANY CNM, WHNP-BC
Practice Location Address:

2817 ROCK MERRITT AVE
FORT BRAGG, NC
28310-0001

Practice Phone: 910-907-8333
Practice Fax:

1548491954 — MS. AMBER ROSE OLIVER LCSW, MSW
Practice Location Address:

2817 ROCK MERRITT AVE
FORT BRAGG, NC
28310-1533

Practice Phone: 910-908-6666
Practice Fax:

Directions to “ JACKIE LYNN DALZELL RD, LDN” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.