Provider Demographics
NPI:1518698307
Name:RALPH, JENNIFER DUNN (RDN, NBC-HWC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DUNN
Last Name:RALPH
Suffix:
Gender:F
Credentials:RDN, NBC-HWC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, NBC-HWC
Mailing Address - Street 1:5540 ROSE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-4209
Mailing Address - Country:US
Mailing Address - Phone:256-476-8048
Mailing Address - Fax:
Practice Address - Street 1:5540 ROSE RIDGE LN
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-4209
Practice Address - Country:US
Practice Address - Phone:256-476-8048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86048653133V00000X
486022576171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered