Provider Demographics
NPI:1578971115
Name:GAWEL, JENNIFER RUTH (BSPSY, RDN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:RUTH
Last Name:GAWEL
Suffix:
Gender:F
Credentials:BSPSY, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4264 W VAIL LN
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-7922
Mailing Address - Country:US
Mailing Address - Phone:517-243-0884
Mailing Address - Fax:
Practice Address - Street 1:120 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2310
Practice Address - Country:US
Practice Address - Phone:517-243-0884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered