Provider Demographics
NPI:1508585381
Name:BEEKER, JENNA (RDN)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:BEEKER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63067 ENGLE RD
Mailing Address - Street 2:
Mailing Address - City:CONSTANTINE
Mailing Address - State:MI
Mailing Address - Zip Code:49042-9729
Mailing Address - Country:US
Mailing Address - Phone:269-858-6968
Mailing Address - Fax:
Practice Address - Street 1:63067 ENGLE RD
Practice Address - Street 2:
Practice Address - City:CONSTANTINE
Practice Address - State:MI
Practice Address - Zip Code:49042-9729
Practice Address - Country:US
Practice Address - Phone:269-858-6968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered