Provider Demographics
NPI:1730996554
Name:TRETTEL, JAMIE DENISE (RDN)
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:DENISE
Last Name:TRETTEL
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29739 68TH ST N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-1614
Mailing Address - Country:US
Mailing Address - Phone:660-624-0030
Mailing Address - Fax:
Practice Address - Street 1:29739 68TH ST N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-1614
Practice Address - Country:US
Practice Address - Phone:660-624-0030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND8431133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered