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General NPI Number Information
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NPI Number | 1679477400
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Entity Type | Individual
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Provider Name | MIKAYLA JEKABSONS
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Gender |
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 4907 TELEPHONE RD
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City | PASCAGOULA
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State | MS
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Zip | 39567-1823
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Country | US
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Telephone | 833-355-2160
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Fax |
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Provider Business Mailing Address
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Address Line | 5913 CHICOPEE TRCE
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3545
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 2298
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License Number State | MS
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