Jessica Houdyshell, RD, LD, CDE
Individual provider Active NPI Registered Dietitian · Lamar, MO
NPI 1831214766 · NPPES record last updated May 17, 2013
Key facts
- NPI
- 1831214766
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 2004008859 (MO)
- Practice address
- 29 NW 1St LN
Lamar, MO 64759-8105 - Phone
- (417) 681-5263
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2004008859 | MO | Yes |
Addresses
Primary practice location
29 NW 1St LN
Lamar, MO 64759-8105
Mailing address
4202 S Sergeant Ave
Joplin, MO 64804-4500
Phone (417) 540-6729
Other providers in Lamar, MO
- Adam Hewitt
- Sarah Ann Higdon
- Julie E Hinds
- Home Town Chiropractic, LLC
- Thomas A Hopkins
- Inez Shields LLC
- Jabez Village, Inc
- Nancy Gayle Jamerson
- Clarence Tucker Joustra
- Amy Kaelke
All providers in Lamar, MO · Registered Dietitian in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2013. 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.