Individual
MS. JILL ANN MONGENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MACC RD LDN
Contact information
Practice address
4295 KEISLING RIDGE RD, MONROE, TN 38573
(615) 479-0869
Mailing address
4295 KEISLING RIDGE RD, MONROE, TN 38573
(615) 479-0869
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3549
TN
133V00000X
Registered Dietitian
L005652
NC
Other
Enumeration date
02/06/2020
Last updated
02/06/2020
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