Provider Demographics
NPI:1417594185
Name:CARTER, JENNIFER NELSON (RD)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:NELSON
Last Name:CARTER
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 1:4959 SPRING ROCK RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-1642
Mailing Address - Country:US
Mailing Address - Phone:205-999-3311
Mailing Address - Fax:
Practice Address - Street 1:3125 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-4159
Practice Address - Country:US
Practice Address - Phone:205-999-3311
Practice Address - Fax:205-868-1314
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-02
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1326133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty