Provider Demographics
NPI:1447471958
Name:JONES, ANNA MONTGOMERY (RD, LD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MONTGOMERY
Last Name:JONES
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2898 HADLEY RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-3504
Mailing Address - Country:US
Mailing Address - Phone:850-321-6387
Mailing Address - Fax:
Practice Address - Street 1:2898 HADLEY RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-3504
Practice Address - Country:US
Practice Address - Phone:850-321-6387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002425133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA71BBBCJMedicare PIN