MEDICARE: JENNIFER BARRELL LDN

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	133N00000X	Nutritionist	ND8375	FL

General Provider Information

NPI Number	:	1942727078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER BARRELL LDN

Provider Business Mailing Address
First Line	:	15341 CORTONA WAY
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34120-0675
Country	:	US
Telephone Number	:	954-661-0435
Fax Number	:

Provider Business Practice Location Address
First Line	:	3531 BONITA BAY BLVD STE 300
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-1704
Country	:	US
Telephone Number	:	239-676-5249
Fax Number	:

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

Provider Enumeration Date	:	08/29/2017
Last Update Date	:	08/29/2017

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