Individual
MRS. JENNIFER LYNN CONFORTINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CD-N
Contact information
Practice address
853 N CHURCH ST STE 720C, SPARTANBURG, SC 29303-3003
(864) 560-6419
(864) 560-7498
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
001142
CT
133V00000X
Registered Dietitian
Primary
2123
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DT1205
—
SC
01
—
Q703766066
MEDICARE PIN
SC
Enumeration date
11/07/2014
Last updated
03/08/2021
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