Mckenzie Jackson, RD, LDN | |
1923 Hampton Dr, Lebanon, TN 37087-4236 | |
(615) 974-7451 | |
Not Available |
Full Name | Mckenzie Jackson |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 1923 Hampton Dr, Lebanon, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609518505 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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133V00000X | Dietitian, Registered | 4062 (Tennessee) | Primary |
Provider Name | Edisonhealth Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1447850912 PECOS PAC ID: 7214332220 Enrollment ID: O20210827003081 |
Mailing Address | Practice Location Address |
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Mckenzie Jackson, RD, LDN 1923 Hampton Dr, Lebanon, TN 37087-4236 Ph: () - | Mckenzie Jackson, RD, LDN 1923 Hampton Dr, Lebanon, TN 37087-4236 Ph: (615) 974-7451 |
Linsey Radford, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1616 W Main St Ste 300, Lebanon, TN 37087 Phone: 615-322-6000 | |
Mrs. Michelle Ross, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1616 W Main St Ste 300, Lebanon, TN 37087 Phone: 615-322-6000 | |
Sara Marie Vopicka, MS, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 932 E Baddour Pkwy, Lebanon, TN 37087 Phone: 615-444-1836 | |
Kristen Peterson, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 132 N Hatton Ave, Lebanon, TN 37087 Phone: 615-563-3892 |