MEDICARE: JESSI PHILLIPS NUTRITION PLLC

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

General Provider Information

NPI Number	:	1306789342
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JESSI PHILLIPS NUTRITION PLLC

Provider Business Mailing Address
First Line	:	220 KATHRYN DR
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80537-6166
Country	:	US
Telephone Number	:	970-391-7401
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 KATHRYN DR
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80537-6166
Country	:	US
Telephone Number	:	970-391-7401
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED DIETITIAN
Name	:	JESSI NICOLE PHILLIPS
Credential	:	RD
Telephone Number	:	970-391-7401

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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