Individual
JESSICA B DOORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 391-6814
(616) 391-3892
Mailing address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 391-6814
(616) 391-3892
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
992353
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
01/29/2020
Last updated
01/29/2020
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