| Mrs Jennifer Marie Graham, MS, RDN, CSP, LD/N | |
|
348 Enterprise Dr Ste B, Valdosta, GA 31601-5697 | |
| (904) 710-8714 | |
| Not Available |
| Full Name | Mrs Jennifer Marie Graham |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 348 Enterprise Dr Ste B, Valdosta, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942893136 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133VN1004X | Dietitian, Registered - Nutrition, Pediatric | ND7159 (Florida) | Secondary |
| 133V00000X | Dietitian, Registered | ND7159 (Florida) | Primary |
| Provider Name | Openloop Healthcare Partners Pc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1245820661 PECOS PAC ID: 2668871898 Enrollment ID: O20210928000424 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Jennifer Marie Graham, MS, RDN, CSP, LD/N 7789 Deer Pond Ln, Tallahassee, FL 32309-9023 Ph: (904) 710-8714 | Mrs Jennifer Marie Graham, MS, RDN, CSP, LD/N 348 Enterprise Dr Ste B, Valdosta, GA 31601-5697 Ph: (904) 710-8714 |
Ms. Denise K. Fields, LICENSED DIETITIAN Dietitian Medicare: Accepting Medicare Assignments Practice Location: 733 Lake Laurie Dr, Valdosta, GA 31605 Phone: 229-630-3833 | |
Ms. Barbara P Lane, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2501 N Patterson St, Valdosta, GA 31602 Phone: 229-259-4997 Fax: 229-249-5060 | |
Mrs. Katherine M Sommer, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2501 N Patterson St, Valdosta, GA 31602 Phone: 229-259-4139 Fax: 229-259-4925 | |
Ms. Holly L. Rountree, LICENSED DIETITIAN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2501 N Patterson St, Valdosta, GA 31602 Phone: 229-259-4630 Fax: 229-259-4925 | |
Mary Gerber, RD/LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 206 S Patterson St, Valdosta, GA 31601 Phone: 229-245-6565 | |
Chad Wesley Eisenhart, RDN, LDN Dietitian Medicare: Accepting Medicare Assignments Practice Location: 3018 N Patterson St, Valdosta, GA 31602 Phone: 229-433-7200 Fax: 229-433-7235 | |
Denise Fields, Rdn, Llc Dietitian Medicare: Medicare Enrolled Practice Location: 2804 N Oak St Ste C, Valdosta, GA 31602 Phone: -- |