Healthcare Provider Details

I. General information

NPI: 1205132883
Provider Name (Legal Business Name): JENNA LEIGH MAYERS MS, RD, LMNT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2011
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S 48TH ST
LINCOLN NE
68506-1283
US

IV. Provider business mailing address

1600 S 48TH ST
LINCOLN NE
68506-1283
US

V. Phone/Fax

Practice location:
  • Phone: 402-489-0200
  • Fax:
Mailing address:
  • Phone: 402-489-0200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number979
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1024772
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: