Provider Demographics
NPI:1366486813
Name:GILMORE, JANET LYNN (RD)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:LYNN
Last Name:GILMORE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 ROANOKE BLVD
Mailing Address - Street 2:NUTRITION SERVICE (120)
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-6404
Mailing Address - Country:US
Mailing Address - Phone:540-982-2464
Mailing Address - Fax:540-983-1059
Practice Address - Street 1:1970 ROANOKE BLVD
Practice Address - Street 2:NUTRITION SERVICE (120)
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-6404
Practice Address - Country:US
Practice Address - Phone:540-982-2464
Practice Address - Fax:540-983-1059
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA674979OtherDIETETIC REGISTRATION