Individual
MRS. GEORGIA A JANSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS RD LDN
Contact information
Practice address
1005 BROADWAY ST, QUINCY, IL 62301-2834
(217) 223-8400
(217) 223-9716
Mailing address
1005 BROADWAY ST, QUINCY, IL 62301-2834
(217) 223-8400
(217) 223-9716
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164-000168
IL
133V00000X
Registered Dietitian
2004029301
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00132009
BLUE CROSS BLUE SHIELD
IL
01
—
002410837
UNITED HEALTH CARE
IL
01
—
075113
QUINCY HEALTH CARE MGMT.
IL
01
—
GJ1068001
AMERICAN SPECIALTY HEALTH
IL
Enumeration date
08/10/2005
Last updated
08/17/2011
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