Provider Demographics
NPI:1699974766
Name:FLEMING, JENNIFER ANNE (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANNE
Last Name:FLEMING
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 E PARK AVE
Mailing Address - Street 2:NUTRITION AND CULINARY SERVICES
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-6701
Mailing Address - Country:US
Mailing Address - Phone:814-231-7195
Mailing Address - Fax:814-231-7118
Practice Address - Street 1:1800 E PARK AVE
Practice Address - Street 2:NUTRITION AND CULINARY SERVICES
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-6701
Practice Address - Country:US
Practice Address - Phone:814-231-7195
Practice Address - Fax:814-231-7118
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003674133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered