Provider Demographics
NPI:1376834713
Name:JONES, KIMBERLY ROBIN (RD, CDE)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ROBIN
Last Name:JONES
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 TORQUAY LOOP
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23236-1351
Mailing Address - Country:US
Mailing Address - Phone:804-314-9154
Mailing Address - Fax:804-674-6050
Practice Address - Street 1:2601 TORQUAY LOOP
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23236-1351
Practice Address - Country:US
Practice Address - Phone:804-314-9154
Practice Address - Fax:804-674-6050
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA803838133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered