Individual
KATHERINE M JENNISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD LDN
Contact information
Practice address
400 HEALTH PARK BLVD, ST AUGUSTINE, FL 32086-5784
(904) 819-4404
Mailing address
87 PONTE VEDRA COLONY CIR, PONTE VEDRA BEACH, FL 32082-4710
(978) 807-7205
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND5590
FL
Other
Enumeration date
06/04/2007
Last updated
05/19/2011
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