Healthcare Provider Details

I. General information

NPI: 1790615888
Provider Name (Legal Business Name): JENNIFER ABERNATHY MS, RD, CNSC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 S COTTONWOOD ST
MURRAY UT
84107-5701
US

IV. Provider business mailing address

2026 E LINCOLN LN
HOLLADAY UT
84124-2764
US

V. Phone/Fax

Practice location:
  • Phone: 801-507-4936
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number9125587-4901
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: