| Mckenzie Jackson, RD, LDN | |
|
1923 Hampton Dr, Lebanon, TN 37087-4236 | |
| (615) 974-7451 | |
| Not Available |
| Full Name | Mckenzie Jackson |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 1923 Hampton Dr, Lebanon, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609518505 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 4062 (Tennessee) | Primary |
| Provider Name | Edisonhealth Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1447850912 PECOS PAC ID: 7214332220 Enrollment ID: O20210827003081 |
| Mailing Address | Practice Location Address |
|---|---|
| Mckenzie Jackson, RD, LDN 1923 Hampton Dr, Lebanon, TN 37087-4236 Ph: () - | Mckenzie Jackson, RD, LDN 1923 Hampton Dr, Lebanon, TN 37087-4236 Ph: (615) 974-7451 |
Mrs. Michelle Ross, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1616 W Main St Ste 300, Lebanon, TN 37087 Phone: 615-322-6000 | |
Kerri Shingleton, MS, RD, LDN, CNSC Dietitian Medicare: Not Enrolled in Medicare Practice Location: 203 Fister Dr, Lebanon, TN 37090 Phone: 865-405-2752 | |
Kristen Peterson, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 132 N Hatton Ave, Lebanon, TN 37087 Phone: 615-563-3892 |