| Jessica Divis, RD | |
|
10752 N 89th Pl Ste 114b, Scottsdale, AZ 85260-6730 | |
| (623) 399-6825 | |
| (623) 505-3474 |
| Full Name | Jessica Divis |
|---|---|
| Gender | Female |
| Speciality | Registered Dietitian Or Nutrition Professional |
| Experience | 8 Years |
| Location | 10752 N 89th Pl Ste 114b, Scottsdale, Arizona |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386222396 | NPI | - | NPPES |
| 86094146 | Other | AZ | COMMISON ON DIETETIC REGISTRATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 86094146 (Arizona) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Am Nutrition Services | 1254430580 | 48 |
| Provider Name | Am Nutrition Services |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1003011602 PECOS PAC ID: 1254430580 Enrollment ID: O20070627000063 |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Divis, RD 18001 N 79th Ave Ste A12, Glendale, AZ 85308-8398 Ph: (623) 399-6825 | Jessica Divis, RD 10752 N 89th Pl Ste 114b, Scottsdale, AZ 85260-6730 Ph: (623) 399-6825 |
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