Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacqueline Marie Wyman, MS, RD, LD

Individual provider Registered Dietitian · NPI 1073073045

Jacqueline Marie Wyman, MS, RD, LD is a Registered Dietitian in Phoenix, Arizona. Licensed in Arizona and Ohio. Registered with an NPI since 2019.

Licensed in
AZ, OH
In the registry since
2019
Specialties on file
2
What do these letters mean?
MS — Master of Science
A graduate science degree.
RD — Registered Dietitian
A credentialed nutrition professional.
LD — Licensed Dietitian
A dietitian licensed by a state board.

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Practice location Address checks out

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone: (602) 933-0940
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 86066765 (AZ)
Registered Dietitian Taxonomy 133V00000X · Licence LD.08638 (OH)

Record details

NPI number1073073045
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , RD , LD
Sole proprietorNo
NPI enumeratedMarch 25, 2019
Last updated in NPPESJune 22, 2022
Certification dateJune 22, 2022

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