Individual
JENNIFER ANN HERINGHAUSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
3600 BUSINESS HWY 151 E, MARION, IA 52302
(319) 377-4803
Mailing address
728 BRODERICK DR NE, UNIT C, CEDAR RAPIDS, IA 52402-8380
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
002083
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164.005061
LICENSE #
IL
Enumeration date
06/26/2012
Last updated
07/26/2013
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