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General NPI Number Information
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NPI Number | 1750700795
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Entity Type | Individual
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Provider Name | JESSICA BROWN SPRUILL RDN, LDN
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Gender | Female
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Dates
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Enumeration Date | 04/07/2014
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Last Update Date | 04/07/2014
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Provider Practice Location Address
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Address Line | 718 EVANS STREET
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City | AHOSKIE
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State | NC
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Zip | 27910
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Country | US
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Telephone | 252-862-4217
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Fax | 252-332-4494
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Provider Business Mailing Address
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Address Line | P.O. BOX 246 801 NORTH KING ST
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City | WINTON
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State | NC
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Zip | 27986
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Country | US
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Telephone | 252-358-7833
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Fax | 252-358-7869
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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 | L004262
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License Number State | NC
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