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Individual

MRS. JENNA BISHOP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD, LDN

Contact information

Practice address
355 NEW SHACKLE ISLAND RD STE 128B, HENDERSONVILLE, TN 37075-2479
(615) 492-6116
(615) 334-8962
Mailing address
3127 W CHADWICK LN, PEORIA, IL 61614-1018
(309) 713-6502

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
164005610
IL
133V00000X
Registered Dietitian
Primary
4791
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
164005610
RD LICENSE
IL
Enumeration date
03/17/2016
Last updated
12/03/2024
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