Shank, Jackie Sue

Shank, Jackie Sue is an sole proprietor health care provider with primary practice located at 401 Porpoise Point Dr , St Augustine FL 32084-2959. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Shank, Jackie Sue can be contacted via phone (904) 826-4307.

Contact Information

Primary practice address
401 Porpoise Point Dr St Augustine FL 32084-2959
Phone: (904) 826-4307
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X ND812 Florida

Profile Details

NPI number 1427178425
LBN Legal business name Shank, Jackie Sue
Credentials Registered Dietitian (RD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 31st, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers