Individual
JEANINE RIVITUSO KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D.N.
Contact information
Practice address
4614 COUNTRY CLUB RD, WINSTON SALEM, NC 27104-3520
(336) 716-6099
Mailing address
4614 COUNTRY CLUB RD, WINSTON SALEM, NC 27104-3520
(336) 716-6099
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L004828
NC
Other
Enumeration date
06/23/2016
Last updated
01/31/2019
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