Jessica Ann Campbell, RD, LD

Individual provider Active NPI Registered Dietitian · Saint Louis, MO

NPI 1730203449 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1730203449
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
2005001323 (MO)
Practice address
4000 Jennings Station Rd
Saint Louis, MO 63121-3323
Phone
(314) 679-7830
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
County of St Louis Division of Fiscal Management Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2005001323 MO Yes

Addresses

Primary practice location

4000 Jennings Station Rd
Saint Louis, MO 63121-3323

Mailing address

2705 Pomme Meadows Dr
Arnold, MO 63010-2868
Phone (314) 650-2624

Other providers in Saint Louis, MO

All providers in Saint Louis, MO · Registered Dietitian in Missouri

Sources for this page

Verify at the official NPI Registry.