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Individual

TRINE FAIRWEATHER-JENSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
960 E WALNUT LAWN ST STE 201, SPRINGFIELD, MO 65807-7865
(417) 269-4450
Mailing address
34 SUNNYBROOK CIR, FAIR GROVE, MO 65648-8099

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2008028023
MO

Other

Enumeration date
12/30/2022
Last updated
12/30/2022
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