Provider Demographics
NPI:1689292054
Name:GALLAND, JESSICA ANN (RDN, LD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:GALLAND
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 E SELTICE WAY
Mailing Address - Street 2:STE A PMB 1031
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-7991
Mailing Address - Country:US
Mailing Address - Phone:702-530-7537
Mailing Address - Fax:
Practice Address - Street 1:2600 E SELTICE WAY
Practice Address - Street 2:STE A PMB 1031
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-7991
Practice Address - Country:US
Practice Address - Phone:702-530-7537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-11
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV86146565133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered