MEDICARE: JANE GUO RDN LLC

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
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1144059833
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JANE GUO RDN LLC

Provider Business Mailing Address
First Line	:	1801 PEACHTREE ST NE STE 350
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-1895
Country	:	US
Telephone Number	:	770-756-6291
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 PEACHTREE ST NE STE 350
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-1895
Country	:	US
Telephone Number	:	770-756-6291
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED DIETITIAN
Name	:	JANE GUO
Credential	:	MCN, RD, LD
Telephone Number	:	770-756-6291

Provider Enumeration Date	:	07/30/2024
Last Update Date	:	04/07/2026

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