Provider Demographics
NPI:1417327149
Name:ZIPFEL, ASHLEY SUSAN JEFFERS (RDN, LD, CLT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SUSAN JEFFERS
Last Name:ZIPFEL
Suffix:
Gender:F
Credentials:RDN, LD, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10285 AUGUSTA LN
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-7508
Mailing Address - Country:US
Mailing Address - Phone:937-570-2275
Mailing Address - Fax:
Practice Address - Street 1:10285 AUGUSTA LN
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-7508
Practice Address - Country:US
Practice Address - Phone:937-570-2275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7768133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered