MEDICARE: JENNIFER JAMES MS, RD, LD

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	DT05017	TX

General Provider Information

NPI Number	:	1841226032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER JAMES MS, RD, LD

Provider Business Mailing Address
First Line	:	109 AUGUSTA DR
Second Line	:
City	:	SANTA TERESA
State	:	NM
Zip	:	88008-9612
Country	:	US
Telephone Number	:	915-544-3000
Fax Number	:	915-544-3003

Provider Business Practice Location Address
First Line	:	4120 RIO BRAVO ST
Second Line	:	STE. 113
City	:	EL PASO
State	:	TX
Zip	:	79902-1052
Country	:	US
Telephone Number	:	915-544-3000
Fax Number	:	915-544-3003

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	07/08/2007

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