Provider Demographics
NPI:1477038842
Name:HEMMINGER, JANE MORGAN (RDLD, CSG, CPT)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:MORGAN
Last Name:HEMMINGER
Suffix:
Gender:F
Credentials:RDLD, CSG, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 PLEASANT VIEW DR
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50315-2127
Mailing Address - Country:US
Mailing Address - Phone:515-490-6362
Mailing Address - Fax:
Practice Address - Street 1:1501 PLEASANT VIEW DR
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50315-2127
Practice Address - Country:US
Practice Address - Phone:515-490-6362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00669133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered