Provider Demographics
NPI:1285174524
Name:RODRIGUEZ JARAMILLO, JENNIFER (RD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:RODRIGUEZ JARAMILLO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800 HILLWOOD PKWY STE 140
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76177-1532
Mailing Address - Country:US
Mailing Address - Phone:682-478-4130
Mailing Address - Fax:
Practice Address - Street 1:9800 HILLWOOD PKWY STE 140
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76177-1532
Practice Address - Country:US
Practice Address - Phone:682-478-4130
Practice Address - Fax:140-855-3951
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT84672133VN1004X
TX#DT84672133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric