Provider Demographics
NPI:1326010414
Name:KAPPEN, JENNIFER JO (RD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JO
Last Name:KAPPEN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:JO
Other - Last Name:HELMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:4011 WORONZOF DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99517-1419
Mailing Address - Country:US
Mailing Address - Phone:575-513-5414
Mailing Address - Fax:
Practice Address - Street 1:1200 AIRPORT HEIGHTS DR
Practice Address - Street 2:STE 278
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2965
Practice Address - Country:US
Practice Address - Phone:907-929-4263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK156133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered