MEDICARE: JENNIFER ZELL GILBREATH MS, RD, CSP,LD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133VN1004X	Pediatric Nutrition Registered Dietitian	DT07625	TX

General Provider Information

NPI Number	:	1437303963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ZELL GILBREATH MS, RD, CSP,LD

Provider Business Mailing Address
First Line	:	1340 EMPIRE CENTRAL DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75247-4022
Country	:	US
Telephone Number	:	469-859-3099
Fax Number	:

Provider Business Practice Location Address
First Line	:	1340 EMPIRE CENTRAL DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75247-4022
Country	:	US
Telephone Number	:	469-859-3099
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2008
Last Update Date	:	06/07/2021

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