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NPI Code Detail

MEDICARE: MRS. JENNIFER PERRY RD, LDN, CDE

MEDICARE: MRS. JENNIFER PERRY RD, LDN, CDE
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
1133V00000XRegistered DietitianL002602NC

General Provider Information

NPI Number : 1003228875
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER PERRY RD, LDN, CDE
Provider Business Mailing Address
First Line : 1031 MORGANTON BLVD SW
Second Line : QUEST4LIFE
City : LENOIR
State : NC
Zip : 28645-5677
Country : US
Telephone Number : 828-757-6450
Fax Number : 828-757-6454
Provider Business Practice Location Address
First Line : 1031 MORGANTON BLVD SW
Second Line : QUEST4LIFE
City : LENOIR
State : NC
Zip : 28645-5677
Country : US
Telephone Number : 828-757-6450
Fax Number : 828-757-6454
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2014
Last Update Date : 05/28/2014

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