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NPI Code Detail

MEDICARE: JEANNA RENEE GLICK

MEDICARE:   JEANNA RENEE GLICK
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 DietitianND6566FL

General Provider Information

NPI Number : 1285599274
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNA RENEE GLICK
Provider Business Mailing Address
First Line : 3857 NW 8TH ST
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33445-1909
Country : US
Telephone Number : 260-415-2382
Fax Number :
Provider Business Practice Location Address
First Line : 3857 NW 8TH ST
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33445-1909
Country : US
Telephone Number : 260-415-2382
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2025
Last Update Date : 12/22/2025

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Directions to “ JEANNA RENEE GLICK ” Practice Location

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