Provider Demographics
NPI:1194126953
Name:PEKARI, JAIME LYNN (RD)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:LYNN
Last Name:PEKARI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 S MEADOWS PKWY APT 1526
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-5997
Mailing Address - Country:US
Mailing Address - Phone:203-415-8753
Mailing Address - Fax:
Practice Address - Street 1:1001 S MEADOWS PKWY APT 1526
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5997
Practice Address - Country:US
Practice Address - Phone:203-415-8753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT922816133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered