Doctor Name: | JENNA DEFORE |
NPI Number: | 1386981702 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD |
License Number: | 37002145A |
Business Practice Address: | 3644 W 46th St Indianapolis, IN - 462286799 |
Business Phone Number: | 8122397936 |
Business Fax Number: | |
Mailing Address: | 3644 W 46th St, INDIANAPOLIS |
State: | IN |
Postal Code: | 462286799 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/04/2013 |
NPI Last Update Date: | 01/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 37002145A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |