# JENNIFER LISA ANTHONY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1760156152
- **Gender:** F
- **Credential:** RD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133VN1004X | Pediatric Nutrition Registered Dietitian | — | — | — |
| 133VN1201X | Obesity and Weight Management Nutrition Registered Dietitian | D-1017 | ID | Yes |

## Other

- **Enumeration date:** 08/09/2021
- **Last updated:** 12/15/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1760156152 | — | ID |