Provider Demographics
NPI:1316395676
Name:MUZZIN, JENNIFER (RDN, LDN)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:MUZZIN
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 NW SPRUCE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-9569
Mailing Address - Country:US
Mailing Address - Phone:772-334-4687
Mailing Address - Fax:
Practice Address - Street 1:900 SE OCEAN BLVD
Practice Address - Street 2:SUITE D232
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2471
Practice Address - Country:US
Practice Address - Phone:772-334-4687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-27
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND6643133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered