MEDICARE: ASHLEY JARVIS RDN

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	L006165	NC
2	133V00000X	Registered Dietitian	DI100000798	DC

General Provider Information

NPI Number	:	1114457298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY JARVIS RDN

Provider Business Mailing Address
First Line	:	217 ELMCREST DR
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-7402
Country	:	US
Telephone Number	:	919-616-0259
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 S MAIN ST STE 212
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-4201
Country	:	US
Telephone Number	:	919-616-0259
Fax Number	:

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

Provider Enumeration Date	:	06/12/2017
Last Update Date	:	07/02/2024

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Directions to “ ASHLEY JARVIS RDN” Practice Location

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