MEDICARE: MS. JILL KAY MACFARLANE RD

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619074945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JILL KAY MACFARLANE RD

Provider Business Mailing Address
First Line	:	3003 N CENTRAL AVENUE, STE 400
Second Line	:	AKDHC, LLC
City	:	PHOENIX
State	:	AZ
Zip	:	85012-0000
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15255 NORTH 40TH STREET
Second Line	:	BLDG 5 STE 135
City	:	PHOENIX
State	:	AZ
Zip	:	85032-0000
Country	:	US
Telephone Number	:	602-943-1231
Fax Number	:

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/12/2008

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