Provider Demographics
NPI:1073231148
Name:KAYLA JESSOP NUTRITION COMPANY
Entity type:Organization
Organization Name:KAYLA JESSOP NUTRITION COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:JESSOP
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, CEDS-C
Authorized Official - Phone:801-888-3397
Mailing Address - Street 1:2890 N 2525 W
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84404-8735
Mailing Address - Country:US
Mailing Address - Phone:801-888-3397
Mailing Address - Fax:
Practice Address - Street 1:2890 N 2525 W
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84404-8735
Practice Address - Country:US
Practice Address - Phone:801-888-3397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-16
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty