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NPI Code Detail

MEDICARE: MS. KAYLA JESSOP RDN, CDN, CEDS-S

MEDICARE:  MS. KAYLA  JESSOP  RDN, CDN, CEDS-S
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 Dietitian008436-1NY
2133V00000XRegistered Dietitian86027147UT

General Provider Information

NPI Number : 1669832853
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KAYLA JESSOP RDN, CDN, CEDS-S
Provider Business Mailing Address
First Line : 2823 W 3325 N
Second Line :
City : FARR WEST
State : UT
Zip : 84404-8632
Country : US
Telephone Number : 801-888-3397
Fax Number :
Provider Business Practice Location Address
First Line : 4578 S HIGHLAND DR STE 380
Second Line :
City : MILLCREEK
State : UT
Zip : 84117-4204
Country : US
Telephone Number : 801-888-3397
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2016
Last Update Date : 11/18/2022

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Directions to “ MS. KAYLA JESSOP RDN, CDN, CEDS-S” Practice Location

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