Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JORDAN DOMENICK, RD
Active Sole ProprietorJORDAN DOMENICK, RD is a Registered Dietitian healthcare provider located in FORT STEWART, Georgia. NPI 1053988477 is currently active in the NPPES registry. Verify at CMS.
Registered Dietitian · FORT STEWART, GA
Registration Details
- NPI Number
- 1053988477
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 4, 2021 (5.1674318266004 yrs)
- Last Updated
- Dec 28, 2023
- Licenses
-
4237 (MN)2022036290 (MO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1061 HARMON AVEFORT STEWART, GA, 313145641Browse GA providers · Browse ZIP 31314
- Phone
- 9124356633
- Primary Specialty
-
Registered Dietitian
133V00000X
- Additional Specialty
- Registered Dietitian
Other Registered Dietitian Providers in FORT STEWART, GA
| Name | Credential | NPI |
|---|---|---|
| MS. RALEIGHETTA VONZELL VARNEDOE | MS, RD, LD | 1306847736 |
| ELIZABETH ANNE VOTTA | MS RD LDN | 1588696074 |
| PRISCILLA C PACKNETT | RD, LDN | 1134233257 |
| ERICKA MARIE CISCO | RD | 1538251095 |
| YI-LING LEE | R.D. | 1285767905 |
| MICHELLE L YETT | — | 1780820035 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.