Healthcare Provider Details

I. General information

NPI: 1891659322
Provider Name (Legal Business Name): JENNIFER BABBIE RD, LD, CDCES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER FITZGERALD RD, LD

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5445 MERIDIAN MARK RD STE 475
ATLANTA GA
30342-4755
US

IV. Provider business mailing address

1146 ANNIE LN SW
MABLETON GA
30126-1587
US

V. Phone/Fax

Practice location:
  • Phone: 404-851-6023
  • Fax:
Mailing address:
  • Phone: 678-232-4253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number974029
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: