Provider Demographics
NPI:1316653082
Name:ROLFSON, JILL J (RD, LMNT)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:J
Last Name:ROLFSON
Suffix:
Gender:F
Credentials:RD, LMNT
Other - Prefix:
Other - First Name:JILL;
Other - Middle Name:J
Other - Last Name:BENES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 24607
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-0607
Mailing Address - Country:US
Mailing Address - Phone:402-955-5400
Mailing Address - Fax:402-955-3674
Practice Address - Street 1:2121 S 56TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2111
Practice Address - Country:US
Practice Address - Phone:402-486-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1276133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric