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NPI Code Detail

MEDICARE: JESSICA NELSON REGISTERED DIETITIAN

MEDICARE: JESSICA NELSON REGISTERED DIETITIAN
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
1133V00000XRegistered Dietitian164.023037IL
2133V00000XRegistered DietitianDN009440PA

General Provider Information

NPI Number : 1114630571
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA NELSON REGISTERED DIETITIAN
Provider Business Mailing Address
First Line : 3362 ROSEMONT CT
Second Line :
City : ROCHESTER
State : MI
Zip : 48306-4705
Country : US
Telephone Number : 269-680-7041
Fax Number :
Provider Business Practice Location Address
First Line : 5750 BAUM BLVD STE 306
Second Line :
City : PITTSBURGH
State : PA
Zip : 15206-3793
Country : US
Telephone Number : 412-593-2048
Fax Number : 844-311-7396
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2023
Last Update Date : 02/10/2026

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Directions to “ JESSICA NELSON REGISTERED DIETITIAN” Practice Location

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