Provider Demographics
NPI:1427364850
Name:STEPHENS, JENNA TULANE (RD)
Entity Type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:TULANE
Last Name:STEPHENS
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 1:657 WILLOW GROVE ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-1868
Mailing Address - Country:US
Mailing Address - Phone:908-850-7800
Mailing Address - Fax:908-850-7801
Practice Address - Street 1:657 WILLOW GROVE ST
Practice Address - Street 2:SUITE 401
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-1868
Practice Address - Country:US
Practice Address - Phone:908-850-7800
Practice Address - Fax:908-850-7801
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered