Provider Demographics
NPI:1821982539
Name:MAYNARD, JULIANNE ROCKETT (RDN, LD)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:ROCKETT
Last Name:MAYNARD
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:JULIANNE
Other - Middle Name:ROSE
Other - Last Name:ROCKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, LD
Mailing Address - Street 1:881 USS JAMES MADISON RD
Mailing Address - Street 2:
Mailing Address - City:KINGS BAY
Mailing Address - State:GA
Mailing Address - Zip Code:31547-2531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:881 USS JAMES MADISON RD
Practice Address - Street 2:
Practice Address - City:KINGS BAY
Practice Address - State:GA
Practice Address - Zip Code:31547-2531
Practice Address - Country:US
Practice Address - Phone:912-573-4215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND11464133V00000X
GALD007511133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered