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NPI Code Detail

MEDICARE: MS. JORDAN L CHAUSSE MS, RDN

MEDICARE:  MS. JORDAN L CHAUSSE  MS, RDN
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 DietitianLDN01105RI

General Provider Information

NPI Number : 1922666031
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JORDAN L CHAUSSE MS, RDN
Provider Business Mailing Address
First Line : 320 PHILLIPS ST
Second Line :
City : NORTH KINGSTOWN
State : RI
Zip : 02852-5166
Country : US
Telephone Number : 413-329-7026
Fax Number :
Provider Business Practice Location Address
First Line : 320 PHILLIPS ST
Second Line :
City : NORTH KINGSTOWN
State : RI
Zip : 02852-5166
Country : US
Telephone Number : 401-471-7413
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2019
Last Update Date : 11/10/2023

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