MS. JACQUELINE MARY MAILLET (NPI# 1104802537) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104802537 |
| Entity Type | Individual |
| Full Name | MS. JACQUELINE MARY MAILLET |
| Credential | RD |
| Practice Address |
468 74th St N Malmstrom Afb, Health and Wellness Center Great Falls MT 59402-6780 |
| Mailing Address |
12647 Olive Blvd Saint Louis MO 63141-6345 |
| Practice Telephone | 4067312404 |
| Mailing Telephone | 8003253982 |
| Enumeration Date | 2005-12-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 439 | MT | Dietary & Nutritional Service Providers |
| Street Address |
468 74TH ST N MALMSTROM AFB, HEALTH AND WELLNESS CENTER |
| City | GREAT FALLS |
| State | MT |
| Zip Code | 59402-6780 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194255166 | Jonathan Tankersley | Dentist | 7300 Perimeter Rd, Malmstrom Afb, Mt 59402, Dental Clinic, Apo, AA 59402 | 2017-06-13 |
| 1780061960 | Usv Optical Inc | Eyewear Supplier (Equipment, not the service) | 7200 Perimeter Rd., Bldg 1340, Malmstrom Afb, MT 59402 | 2015-04-27 |
| 1396181533 | 341st Medical Group | Military/U.S. Coast Guard Pharmacy | 341 Mdg/mdss/sgsa 7300 N Perimeter Rd, Bldg 2040, Malstrom Afb, MT 59402 | 2013-05-15 |
| 1205098258 | Dennis Gordon Vanhook | Social Worker | 7300 N Peirmeter Road, 341st Medical Group, Malmstrom Afb, MT 59402 | 2008-07-01 |
| 1437205119 | Misty Dawn Robertson | Dental Hygienist | 3700 N Perimeter Road, Malmstrom Afb, MT 59402 | 2007-01-26 |
| 1699738278 | Carol F Nelson | Nurse Practitioner | 7300 North Perimeter Rd, Malmstrom Afb, MT 59402 | 2006-04-06 |
| 1558829408 | Tyler C Mcdaniel | Psychologist | 7300 N Perimeter Rd, Great Falls, MT 59402 | 2019-03-11 |
| 1952541716 | Stacey Renee Vierra | Physician Assistant | 7300 North Perimeter Road, 341 Medical Group, Malmstrom Afb, MT 59402 | 2009-03-05 |
| 1306094461 | Jeremy Gustafson | Pharmacist | 7300 North Perimeter Road, Malmstrom Afb, MT 59402 | 2008-09-03 |
| 1356329817 | Timothy Paul Gacioch | Physician Assistant | 4300 Perimeter Rd, (341st Med Group) Bldg 2040, Room S156, Malmstrom Afb, MT 59402-0001 | 2006-01-05 |
| Find all providers in zip 59402 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235776428 | Martha F Betts | Dietitian, Registered | 10731 Sugar Meadow Ct, Great Falls, VA 22066-4238 | 2019-12-06 |
| 1497260541 | Robert Roger Baerman | Dietitian, Registered | 4032 Ella Ave # 1, Great Falls, MT 59405-3717 | 2017-12-12 |
| 1801299466 | Kelsey Conrow | Dietitian, Registered | 400 13th Ave S Ste 106, Great Falls, MT 59405-4300 | 2014-09-26 |
| 1083966519 | Kristen Draskovic | Dietitian, Registered | 2427 4th Ave N, Great Falls, MT 59401-2813 | 2012-10-08 |
| 1780291591 | Katherine Emily Campbell | Dietitian, Registered | 600 Central Ave Ste 201, Great Falls, MT 59401-3141 | 2020-09-25 |
| 1174133565 | Emily Scheinman | Dietitian, Registered | 600 Central Ave Ste 201, Great Falls, MT 59401-3141 | 2020-07-31 |
| 1205476751 | Sarah Ryan | Dietitian, Registered | 1101 26th St S, Great Falls, MT 59405-5161 | 2020-01-13 |
| 1699282251 | Andrea Michelle Withey | Dietitian, Registered | 1400 29th St S, Great Falls, MT 59405-5315 | 2018-01-04 |
| 1841590403 | Benefis Hospitals, Inc | Dietitian, Registered | 1101 26th St S, Great Falls, MT 59405-5161 | 2010-10-29 |
| 1376788893 | Debra K Misener | Dietitian, Registered | 115 4th St S, Great Falls, MT 59401-3618 | 2008-12-12 |
| Find all providers in GREAT FALLS | ||||
| City | GREAT FALLS |
| Zip Code | 59402 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.