Provider Demographics
NPI:1356832182
Name:FOSTER, JESSICA (RD)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:CLAUSSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:525 W CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:VERMILLION
Mailing Address - State:SD
Mailing Address - Zip Code:57069-1141
Mailing Address - Country:US
Mailing Address - Phone:605-624-5574
Mailing Address - Fax:
Practice Address - Street 1:525 W CHERRY ST
Practice Address - Street 2:
Practice Address - City:VERMILLION
Practice Address - State:SD
Practice Address - Zip Code:57069-1141
Practice Address - Country:US
Practice Address - Phone:605-624-5574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0621133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered