Provider Demographics
NPI:1477610236
Name:SPITZER, JENNIFER HODGSON (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:HODGSON
Last Name:SPITZER
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 COURTNEY LN
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24201-1879
Mailing Address - Country:US
Mailing Address - Phone:336-406-7479
Mailing Address - Fax:
Practice Address - Street 1:110 COURTNEY LN
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24201-1879
Practice Address - Country:US
Practice Address - Phone:336-406-7479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered