Provider Demographics
NPI:1285206698
Name:RAHMAN, JENNIFER (MS, RD, LMNT, CCRC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:RAHMAN
Suffix:
Gender:F
Credentials:MS, RD, LMNT, CCRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7831 CHICAGO CT
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3654
Mailing Address - Country:US
Mailing Address - Phone:140-235-4124
Mailing Address - Fax:402-354-1249
Practice Address - Street 1:7831 CHICAGO CT
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3654
Practice Address - Country:US
Practice Address - Phone:140-235-4124
Practice Address - Fax:402-354-1249
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE666133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered