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General NPI Number Information
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NPI Number | 1780118695
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Entity Type | Individual
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Provider Name | ROCIO VALDEZ-JARDINE R.D.N.
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Gender | Female
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 04/18/2017
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Provider Practice Location Address
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Address Line | 11889 TOM NICHOLS RD
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City | PRINCESS ANNE
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State | MD
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Zip | 21853-3633
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Country | US
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Telephone | 443-783-4561
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Fax |
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Provider Business Mailing Address
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Address Line | 11889 TOM NICHOLS RD
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City | PRINCESS ANNE
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State | MD
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Zip | 21853-3633
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Country | US
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Telephone | 410-968-1200
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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 | D02117
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License Number State | MD
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