Provider Demographics
NPI:1457624553
Name:MEYER, ERIN ELISABETH (RD, LD/N)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ELISABETH
Last Name:MEYER
Suffix:
Gender:F
Credentials:RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13364 BEACH BLVD UNIT 508
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-0267
Mailing Address - Country:US
Mailing Address - Phone:904-476-7188
Mailing Address - Fax:
Practice Address - Street 1:3225 UNIVERSITY BLVD S
Practice Address - Street 2:SUITE 100
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-2762
Practice Address - Country:US
Practice Address - Phone:904-253-2944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 6122133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered