Individual
JENNIFER LYNN WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDLD
Contact information
Practice address
7154 CREEKFRONT DR, FOUNTAIN, CO 80817-4034
(719) 510-8480
Mailing address
7154 CREEKFRONT DR, FOUNTAIN, CO 80817-4034
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
0880
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0880
LD
NM
Enumeration date
01/09/2013
Last updated
01/09/2013
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