Healthcare Provider Details

I. General information

NPI: 1215720321
Provider Name (Legal Business Name): JENNIFER L ZUERCHER PHD, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER L STYLES

II. Dates (important events)

Enumeration Date: 05/22/2025
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1904 MEADOW LN
EDWARDSVILLE IL
62025-5519
US

IV. Provider business mailing address

1904 MEADOW LN
EDWARDSVILLE IL
62025-5519
US

V. Phone/Fax

Practice location:
  • Phone: 919-206-4332
  • Fax:
Mailing address:
  • Phone: 919-206-4332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number164007811
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: