Individual
JINETTE PAE FELLOWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CSG
Contact information
Practice address
9320 GRAND CORDERA PKWY STE 100, COLORADO SPRINGS, CO 80924-7004
(719) 209-8652
Mailing address
640 S STATE ST, DOVER, DE 19901-3530
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN-0000710
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86083707
COMMISSION ON DIETETIC REGISTRATION
CO
Enumeration date
07/08/2018
Last updated
06/30/2024
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