MEDICARE: MRS. ADRIENNE ANGELA JUSTEN RDN,LD

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	LD.5054	OH
2	133VN1006X	Metabolic Nutrition Registered Dietitian	LD.5054	OH
3	133NN1002X	Nutrition Education Nutritionist	LD.5054	OH

General Provider Information

NPI Number	:	1467133793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ADRIENNE ANGELA JUSTEN RDN,LD

Provider Business Mailing Address
First Line	:	3000 ARLINGTON AVE STOP 1108
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2595
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 ARLINGTON AVE STE 2C
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2598
Country	:	US
Telephone Number	:	419-383-3759
Fax Number	:	419-383-2962

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2023
Last Update Date	:	01/22/2026

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