Provider Demographics
NPI:1427225309
Name:IGNACIO, JENNIFER M (MS, RD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:IGNACIO
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 ANNA MARIE CT
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21409-5672
Mailing Address - Country:US
Mailing Address - Phone:410-757-6716
Mailing Address - Fax:
Practice Address - Street 1:1418 ANNA MARIE CT
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21409-5672
Practice Address - Country:US
Practice Address - Phone:410-757-6716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-10
Last Update Date:2008-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered