Provider Demographics
NPI:1225164080
Name:JENNINGS, CATHERINE MARY (RD)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:MARY
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9060 BUCHANAN DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:DE
Mailing Address - Zip Code:19960-2775
Mailing Address - Country:US
Mailing Address - Phone:302-677-3733
Mailing Address - Fax:302-677-4115
Practice Address - Street 1:300 TUSKEGEE BLVD
Practice Address - Street 2:436 ADOS SGGZ
Practice Address - City:DOVER AFB
Practice Address - State:DE
Practice Address - Zip Code:19902
Practice Address - Country:US
Practice Address - Phone:302-677-3733
Practice Address - Fax:302-677-4115
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE865485133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered