Provider Demographics
NPI:1285343566
Name:THOMPSON, JENNIFER E (RD, LD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:E
Other - Last Name:CREAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:648 TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-3202
Mailing Address - Country:US
Mailing Address - Phone:614-864-7225
Mailing Address - Fax:614-626-8335
Practice Address - Street 1:648 TAYLOR RD
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-3202
Practice Address - Country:US
Practice Address - Phone:614-864-7225
Practice Address - Fax:614-626-8335
Is Sole Proprietor?:No
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6273133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered