Individual
MS. JENNIFER L LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
756
NE
133V00000X
Registered Dietitian
756
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
756
MED NUTRITION THERAPIST
NE
01
—
923624
CLINICAL
NE
Enumeration date
03/08/2007
Last updated
03/03/2023
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