Provider Demographics
NPI:1518114123
Name:JONES, JENNA ELIZABETH (RD)
Entity Type:Individual
Prefix:MS
First Name:JENNA
Middle Name:ELIZABETH
Last Name:JONES
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 1:6601 STATE ROUTE 374
Mailing Address - Street 2:
Mailing Address - City:CHATEAUGAY
Mailing Address - State:NY
Mailing Address - Zip Code:12920-2401
Mailing Address - Country:US
Mailing Address - Phone:518-561-7450
Mailing Address - Fax:
Practice Address - Street 1:14 BOOTH DR
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-6404
Practice Address - Country:US
Practice Address - Phone:518-420-6581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered