Provider Demographics
NPI:1326483025
Name:CAUBLE, JENNIFER S (MS, RD, LD, IBCLC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:S
Last Name:CAUBLE
Suffix:
Gender:F
Credentials:MS, RD, LD, IBCLC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:S
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9405 N OAK TRFY
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2233
Mailing Address - Country:US
Mailing Address - Phone:816-412-2900
Mailing Address - Fax:816-412-2915
Practice Address - Street 1:9405 N OAK TRFY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-2233
Practice Address - Country:US
Practice Address - Phone:816-412-2900
Practice Address - Fax:816-412-2915
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1011780133V00000X
MO11245264174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174N00000XOther Service ProvidersLactation Consultant, Non-RN