Provider Demographics
NPI:1225459779
Name:GINGERICH, JOANN (RDN, CD)
Entity Type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:
Last Name:GINGERICH
Suffix:
Gender:F
Credentials:RDN, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6514 HYDE PARK DR
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-8258
Mailing Address - Country:US
Mailing Address - Phone:609-865-7204
Mailing Address - Fax:
Practice Address - Street 1:6514 HYDE PARK DR
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-8258
Practice Address - Country:US
Practice Address - Phone:609-865-7204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-01
Last Update Date:2014-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37002071A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered