Individual
MS. JENNIFER OLSEN POLNIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., C.D.E, PA-C
Contact information
Practice address
303 N KEENE ST STE 301, COLUMBIA, MO 65201-8053
(573) 882-8000
(573) 882-6600
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
0221025253
MO
363A00000X
Physician Assistant
Primary
2016024375
MO
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09720278
DIABETES EDUCATOR CERTIFI
—
01
—
2001025253
STATE LICENSE DIETITIAN
MO
05
—
220039284
—
MO
Enumeration date
05/14/2007
Last updated
03/01/2023
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