Provider Demographics
NPI:1588727739
Name:ELKINS, JENNIFER D (RD)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:D
Last Name:ELKINS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17340 W 12 MILE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-6322
Mailing Address - Country:US
Mailing Address - Phone:248-519-3960
Mailing Address - Fax:248-856-4697
Practice Address - Street 1:17340 W 12 MILE RD STE 103
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-6322
Practice Address - Country:US
Practice Address - Phone:248-234-4212
Practice Address - Fax:248-856-4697
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered