Provider Demographics
NPI:1992313290
Name:GERNE, JESSICA (RDN, CDN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:GERNE
Suffix:
Gender:F
Credentials:RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 BELLEVUE AVE
Mailing Address - Street 2:
Mailing Address - City:LEONARDO
Mailing Address - State:NJ
Mailing Address - Zip Code:07737-1611
Mailing Address - Country:US
Mailing Address - Phone:862-377-3499
Mailing Address - Fax:
Practice Address - Street 1:28 BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:LEONARDO
Practice Address - State:NJ
Practice Address - Zip Code:07737-1611
Practice Address - Country:US
Practice Address - Phone:862-377-3499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-22
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86031095133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered