Provider Demographics
NPI:1629481932
Name:BEST, JENNIFER RAEGAN (MBA, RD, LD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RAEGAN
Last Name:BEST
Suffix:
Gender:F
Credentials:MBA, RD, LD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:RAEGAN
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBA, RD, LD
Mailing Address - Street 1:4920 NE STALLINGS DR
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1254
Mailing Address - Country:US
Mailing Address - Phone:936-645-6942
Mailing Address - Fax:
Practice Address - Street 1:4920 NE STALLINGS DR
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1254
Practice Address - Country:US
Practice Address - Phone:936-645-6942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85007027133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered