Jacquelyn Ehmer, RDN
Individual provider Active NPI Registered Dietitian · Saco, ME
NPI 1043033764 · NPPES record last updated Nov 1, 2024
Key facts
- NPI
- 1043033764
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 86331802 (ME)
- Practice address
- 120 Main St Apt 327
Saco, ME 04072-3534 - Phone
- (631) 559-1959
- NPI assigned
- Nov 1, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86331802 | ME | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86331802 | ME | Yes |
Addresses
Primary practice location
120 Main St Apt 327
Saco, ME 04072-3534
Mailing address
120 Main St Apt 327
Saco, ME 04072-3534
Other providers in Saco, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.