Provider Demographics
NPI:1477204592
Name:JENN LYONS RDN NUTRITION
Entity Type:Organization
Organization Name:JENN LYONS RDN NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:703-924-0430
Mailing Address - Street 1:5718 CLAPHAM RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-5639
Mailing Address - Country:US
Mailing Address - Phone:703-924-0430
Mailing Address - Fax:855-430-7722
Practice Address - Street 1:5718 CLAPHAM RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315-5639
Practice Address - Country:US
Practice Address - Phone:703-924-0430
Practice Address - Fax:855-430-7722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty